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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Insurer’s Exclusion for Claims of Assault & Battery is Effective
Post 5250
Read the full article at https://lnkd.in/gBzt2vw9, see the video at https://lnkd.in/gEBBE-e6 and at https://lnkd.in/gk7EcVn9, and at https://zalma.com/blog plus more than 5250 posts.
Bar Fight With Security is an Excluded Assault & Battery
In The Cincinnati Specialty Underwriters Insurance Company v. Mainline Private Security, LLC, et al., Civil Action No. 24-3871, United States District Court, E.D. Pennsylvania (December 16, 2025) two violent attacks occurred in Philadelphia involving young men, Eric Pope (who died) and Rishabh Abhyankar (who suffered catastrophic injuries). Both incidents involved security guards provided by Mainline Private Security, LLC (“Mainline”) at local bars. The estates of the victims sued the attackers, the bars, and Mainline for negligence and assault/battery. The insurer exhausted a special limit and then denied defense or indemnity to Mainline Private Security.
INSURANCE COVERAGE
Mainline had purchased a commercial ...
Marine Insurer May Dispose of Vessel to Avoid Waste
Post 5249
Read the full article at https://lnkd.in/gfn_UHdp, see the video at https://lnkd.in/gDWVccnr and at https://lnkd.in/gv9nsBqk, and https://zalma.com/blog plus more than 5200 posts.
In Western World Insurance Company v. The Estate Of Shawn Arsenault, No. 25-cv-13413-PGL, United States District Court, D. Massachusetts (December 17, 2025) the USDC was asked to resolve a marine insurance dispute after the sinking of the F/V Seahorse, a commercial fishing vessel, off Cape Cod on June 8, 2025. The vessel’s owner and operator, Shawn Arsenault, died in the incident.
Western World Insurance Company issued a hull insurance policy for the vessel. With no personal representative yet appointed for the estate, the insurer cannot determine the proper payee for the insurance proceeds.
The insurer paid for the vessel’s recovery and removal, and the vessel is now with a salvage company, incurring substantial storage fees. The insurer determined the loss is covered under the ...
Marine Insurer May Dispose of Vessel to Avoid Waste
Post 5249
Read the full article at https://lnkd.in/gfn_UHdp, see the video at https://lnkd.in/gDWVccnr and at https://lnkd.in/gv9nsBqk, and https://zalma.com/blog plus more than 5200 posts.
In Western World Insurance Company v. The Estate Of Shawn Arsenault, No. 25-cv-13413-PGL, United States District Court, D. Massachusetts (December 17, 2025) the USDC was asked to resolve a marine insurance dispute after the sinking of the F/V Seahorse, a commercial fishing vessel, off Cape Cod on June 8, 2025. The vessel’s owner and operator, Shawn Arsenault, died in the incident.
Western World Insurance Company issued a hull insurance policy for the vessel. With no personal representative yet appointed for the estate, the insurer cannot determine the proper payee for the insurance proceeds.
The insurer paid for the vessel’s recovery and removal, and the vessel is now with a salvage company, incurring substantial storage fees. The insurer determined the loss is covered under the ...
Zalma’s Insurance Fraud Letter
Read the full article at https://lnkd.in/dG829BF6; see the video at https://lnkd.in/dyCggZMZ and at https://lnkd.in/d6a9QdDd.
ZIFL Volume 29, Issue 24
Subscribe to the e-mail Version of ZIFL, it’s Free! https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing 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/
Zalma’s Insurance Fraud Letter
Merry Christmas & Happy Hannukah
Read the following Articles from the December 15, 2025 issue:
Read the full 19 page issue of ZIFL at ...
The Professional Claims Handler
Post 5219
Posted on October 31, 2025 by Barry Zalma
An Insurance claims professionals should be a person who:
Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.
How to Create Claims Professionals
To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...
The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...
