See the full video at https://lnkd.in/g8PFPHuh and at https://lnkd.in/gkvM9jvK and at https://zalma.com/blog plus more than 5150 posts.
Suits Between Insurance Agents Excluded by E&O Policy
Post 5197
In Laurence Ziff, individually, and the Ziff agency, LLC v. Allianz Global Risks U.S. Insurance Company f/k/a Fireman’s Fund Insurance Company, Civil Action No. 24-10529, United States District Court, D. New Jersey (September 23, 2025) Laurence Ziff and The Ziff Agency, LLC are insurance brokers sued Defendant Allianz Global Risks U.S. Insurance Company for defense and indemnity to a lawsuit alleging defamation.
FACTS:
Insurance Policy:
Plaintiffs purchased several insurance policies from Defendant, including the policy at issue, which provided “Company Sponsored Life Insurance Agents Errors and Omissions Liability Coverage”.
Plotkin Lawsuit:
The lawsuit arose from a dispute where David Plotkin and Richard Urbealis sued Plaintiffs in New Jersey state court, alleging defamatory statements made by Plaintiff Ziff during a meeting related to the sale of life insurance policies.
Exclusion K:
Defendant denied coverage based on Exclusion K, which disclaims liability for any claim arising out of disputes with other insurance agents or brokers.
LEGAL PRINCIPLES:
Motion to Dismiss:
Defendant filed a motion to dismiss the Amended Complaint for failure to state a claim under Federal Rule of Civil Procedure 12(b)(6).
Exclusion K Interpretation:
The court found that Exclusion K was unambiguous and applicable, as it excluded coverage for disputes between insurance agents and brokers, including those concerning commissions, fees, and client lists.
ANALYSIS
Exclusionary clauses in insurance policies are narrowly construed. The insurer has the burden to prove that an exclusion applies. If there is more than one possible interpretation of the language, courts apply the meaning that supports coverage rather than the one that limits it. If the words used in an exclusionary clause are clear and unambiguous, a court will not engage in a strained construction to support the imposition of liability.
Defendant argued that the Plotkin Lawsuit was a dispute between insurance agents and brokers and that therefore Exclusion K must apply. Plaintiffs concede that Plotkin and Urbealis are “insurance agents” but contend that Plotkin and Urbealis did not sue Plaintiffs as insurance brokers or insurance agents and did not act as insurance brokers or insurance agents in the placement of the life insurance policies at issue.
Contrary to the allegations the record clearly demonstrated that Urbealis and Plotkin were acting as insurance agents when trying to sell life insurance policies to Kurtz. Since the language of Exclusion K is unambiguous and applies here Plaintiffs were not entitled to coverage under the Policy and failed to state a claim upon which relief could be granted under Rule 12(b)(6).
CONCLUSION
Defendant’s motion to dismiss was granted because a court may dismiss a claim with prejudice when leave to amend would be futile. Because Plaintiffs failed to identify any way in which they would be entitled to coverage under the Plan, amending their complaint for a second time would be futile so the case was dismissed.
ZALMA OPINION
Insurance policies are contracts whose terms and conditions, when brought to a court, are interpreted by the court. The Allianz policy excluded disputes between agents and brokers in language that was clear and unambiguous and the dispute was a result of claims made by insurance agents or brokers against the insured insurance agent. No coverage was obvious.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution
Post 5489
Posted on September 14, 2026 by Barry Zalma
Fraudster Refuses to Answer Questions About His Alleged Fraud
See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr
In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.
Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.
After Great American ...
Policy Limits Demand Accepted Settles Claim
Post 5434
Posted on August 26, 2026 by Barry Zalma
See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute
In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange, The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.
FACTUAL BACKGROUND
Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.
Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...
Policy Limits Demand Accepted Settles Claim
Post 5434
Posted on August 26, 2026 by Barry Zalma
See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute
In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange, The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.
FACTUAL BACKGROUND
Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.
Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...
Insurer’s Insistence on Keeping Premium Defeats Claim of Voidance for Breach of Condition
Posted on September 16, 2026 by Barry Zalma
Post 4845
After USAA Learned Ford Had Sold The BMW, It Did Not Attempt To Revoke The Policy And Refund The Amount Ford Had Paid For Coverage and was Estopped or Waived it Right to Revoke Coverage
In Lisa White v. USAA Insurance Agency Incorporated, et al., No. CV-24-00378-PHX-KML, United States District Court, D. Arizona (September 10, 2026) Dezmond Ford purchased a USAA automobile policy covering a 2013 BMW for August 7 through December 27, 2020, and apparently paid the full premium.
Ford later sold the BMW to Jack Eddia without notifying USAA, but kept the policy active to avoid a coverage gap. Eddia obtained title and registration and, on November 1, 2020, struck and killed Lisa White’s son while driving the BMW. USAA had accepted premiums through the accident date and, after learning of the sale, did not refund the premium attributable to the post-sale period. White obtained a $3.75...
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Posted on September 1, 2026 by Barry Zalma
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in educing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/
This issue contains the following articles about insurance fraud:
Long Island Rep. Laura Gillen Is Taking Aim At Criminals Who Have Been Caught Staging Car Accidents.
Time for a Federal Crime of Insurance Fraud
The accidents may be shams, but the felonies would be real. On Thursday, Gillen (D-NY) introduced the Stop Auto Fraud Act of 2026, which would make the “crash for cash” practice a federal offense punishable by up to 10 years behind bars, with sentence enhancements for smash-ups causing injury or death.
Rep. Laura Gillen is hoping her bipartisan bill will become law to give prosecutors a federal crime to prosecute cash for crash ...
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Posted on September 1, 2026 by Barry Zalma
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in educing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/
This issue contains the following articles about insurance fraud:
Long Island Rep. Laura Gillen Is Taking Aim At Criminals Who Have Been Caught Staging Car Accidents.
Time for a Federal Crime of Insurance Fraud
The accidents may be shams, but the felonies would be real. On Thursday, Gillen (D-NY) introduced the Stop Auto Fraud Act of 2026, which would make the “crash for cash” practice a federal offense punishable by up to 10 years behind bars, with sentence enhancements for smash-ups causing injury or death.
Rep. Laura Gillen is hoping her bipartisan bill will become law to give prosecutors a federal crime to prosecute cash for crash ...
