Zalma on Insurance
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Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
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September 30, 2025
Unambiguous Policy Language Applied

Only Vehicles Listed on Policy as a “Covered Auto” Are Entitled to Defense or Indemnity

Post 5198

See the full video at https://rumble.com/v6zn0p0-unambiguous-policy-language-applied.html and at https://youtu.be/gWtoQfgbsok, and at https://zalma.com/blog plus more than 5150 posts.

ATV Not a Covered Auto

In Acuity, a Mutual Insurance Company v. Peak View Roofing Co., Jeffrey Pierce, and Ty Smith, Civil Action No. 24-cv-01300-MDB, United States District Court, D. Colorado (September 23, 2025) resolved an insurance coverage dispute concerning the duty of the insurer to defend a civil lawsuit.

KEY FACTS:

Parties Involved:

The case involves Plaintiff Acuity, Defendant Smith, Defendant Pierce, and Peak View Roofing Co. (PVRC).

Underlying Action:

Defendant Smith alleges he was injured on August 19, 2022, while riding as a passenger in a 2018 Polaris Rzr ATV owned by Bluethread Services, LLC d/b/a Peak View Roofing, LLC and operated by Defendant Pierce.

Insurance Policy:

The Rzr was insured under the Policy as “equipment” rather than a “business auto”. Plaintiff Acuity sought a determination that it has no duty to defend or indemnify Pierce or PVRC .

LEGAL PRINCIPLES:

Contract Interpretation:

An insurance policy is a contract that should be interpreted in line with well-settled principles of contract interpretation. Courts should give the words in the contract their plain and ordinary meaning unless contrary intent is evidenced in the policy. Courts construe coverage provisions liberally in favor of the insured to provide the broadest possible coverage.

Policy Terms:

The policy specifically states that coverage applies only to those autos shown as covered autos. The Rzr is listed as “Scheduled Contractor’s Equipment” under the Policy’s Commercial Inland Marine Coverage and is not, therefore, a covered auto.

Undisputed Material Facts

The Rzr was not listed on the Policy as a “Business Auto.” The Rzr is listed in the Policy as “Scheduled Contractor’s Equipment” under the Policy’s Commercial Inland Marine Coverage. The Contractor’s Equipment Coverage Form does not include coverage for bodily injury or create a duty of defense or indemnity on the part of Acuity.

ANALYSIS

Whether there is a genuine dispute as to a material fact depends upon whether the evidence presents a sufficient disagreement to require submission to a jury or conversely, whether the evidence is so one-sided that one party must prevail as a matter of law.

Here, the threshold question was whether the Court should look beyond the explicit terms of the Policy-which lists the Rzr as equipment-in an attempt to uncover some underlying intent to include the Rzr as a covered auto. The Court saw no basis for doing so.

While it is true that a court should look to the parties’ intent to resolve “ambiguities” in an insurance policy, this is not a case of ambiguity. Indeed, there can be no dispute over the meaning of certain Policy terms. The language is explicit and clear, the Rzr is covered as equipment. Courts may not force an ambiguity in order to resolve it against the insurer.

Based on the undisputed Policy language and declarations, the Rzr was equipment, not a covered auto at the time of the accident. Therefore, Plaintiff does not have a duty to defend or indemnify Defendant Pierce or PVRC in the Underlying Action.

Plaintiff Acuity’s Motion for Summary Judgment Pursuant to F.R.C.P. 56 was granted.

ZALMA OPINION

If the plaintiff’s wanted the Rzr ATV to be considered a covered auto they only needed to ask Acuity to insure it as such not as “equipment.” Since the plaintiff intended to insure the ATV as equipment accidents causing injury due to the operation of the Rzr there was no coverage for defense or indemnity under the auto liability insurance.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:07:50
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32 minutes ago
An International Convention Requiring Enforcement of Foreign Arbitration Award Doesn’t Apply

Louisiana Statute Prevents Enforcement of Contract Term Requiring Arbitration of Disputes

Post 5241

Read the full article at https://www.linkedin.com/pulse/international-convention-requiring-enforcement-award-barry-sttdc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.

In Town of Vinton v. Indian Harbor Insurance Company, Nos. 24-30035, 24-30748, 24-30749, 24-30750, 24-30751, 24-30756, 24-30757, United States Court of Appeals, Fifth Circuit (December 8, 2025) municipal entities including the Town of Vinton, et al sued domestic insurers after dismissing foreign insurers with prejudice. The insurers sought arbitration under the Convention on the Recognition and Enforcement of Foreign Arbitral Awards (the “Convention”) but the court held Louisiana law — prohibiting arbitration clauses in such policies—controls, as the Convention does not apply absent foreign parties who ...

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December 10, 2025
$500 a Day Penalty if no Workers’ Compensation Insurance

Refusal to Provide Workers’ Compensation is Expensive
Post 5240

Read the full article at https://lnkd.in/guC9dnqA, see the video at https://lnkd.in/gVxz-qmk and at https://lnkd.in/gUTAnCZw, and at https://zalma.com/blog plus more than 5200 posts.

In Illinois Department of Insurance, Insurance Compliance Department v.USA Water And Fire Restoration, Inc., And Nicholas Pacella, Individually And As Officer, Nos. 23WC021808, 18INC00228, No. 25IWCC0467, the Illinois Department of Insurance (Petitioner) initiated an investigation after the Injured Workers’ Benefit Fund (IWBF) was added to a pending workers’ compensation claim. The claim alleged a work-related injury during employment with the Respondents who failed to maintain workers’ compensation Insurance.

Company Overview:

USA Water & Fire Restoration, Inc. was incorporated on January 17, 2014, and dissolved on June 14, 2019, for failure to file annual reports and pay franchise taxes. It then operated under assumed names including USA Board Up & Glass Co. and USA Plumbing and Sewer. The business ...

00:09:22
December 09, 2025
Go Directly to Jail, Do not Pass Go

Arsonist Incompetently Moves Pro Se to Avoid Prison

Post 5239

Read the full article at https://lnkd.in/gRX8TfKn, see the video at https://lnkd.in/gY3Jvnqp and at https://lnkd.in/gRCaaf-3, and at https://zalma.com/blog plus more than 5200 posts.

In Christopher A. Barosh v. Morris Houser, et al., Civ. No. 22-0769, United States District Court, E.D. Pennsylvania (November 25, 2025) a convicted arsonist and insurance fraudster moved the USDC acting in Pro se filed Objections to Magistrate Judge Reid’s Recommendation that the US District Judge dismiss his § 2254 Petition to avoid jail.

BACKGROUND

In October 2005, Barosh set fire to his girlfriend’s Philadelphia home — some 25 hours before the cancellation of the property’s insurance policy. Several witnesses saw Barosh leaving the property shortly before the fire erupted. After the fire, Barosh made “two separate admissions of guilt.”

He attempted to pay an acquaintance to provide him with an alibi for the time of the arson. The eyewitnesses, brother, and ...

00:07:00
October 31, 2025
The Zalma Philosophy of Claims Handling – Part 9

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 ...

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October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

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 ...

post photo preview
October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

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 ...

post photo preview
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