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 claims, the basic insurance policies used by the insurer, and assigned to handle minor insurance claims. I had no difficulty with the reading since I was a college graduate and had simultaneously enrolled in a night law school.
After I had learned the basics from the reading and assistance of an experienced claims supervisor I was sent to ride along with experienced adjusters in every type of insurance sold by my employer. I rode, and learned from, a surety adjuster, a workers’ compensation adjuster, first party property adjusters and third party liability adjusters. I was then sent to the insurer’s home office for a full month of classroom training on everything from the effect of traumatic injuries, reconstruction of fire, wind, or water damaged structures, tort law, contract law, and insurance policy interpretation.
After completing the classroom training I was allowed to deal with small claims by telephone under the very close supervision of an experienced claims supervisor and the claims manager.
Eventually I convinced my supervisor that I knew the basics of the insurance claims business, how to investigate a claim, how to interview an insured and independent witnesses and how to evaluate a claim. I was assigned a company car, a Nash Ambassador, and claims to handle in person from small water damages, kitchen fires, and other small claims until my abilities improved and I was able to handle a major claim with the assistance of the manager, supervisor and experienced staff adjusters and consultants. I was also able to apply to my claims work with what I was learning in law school.
It took me more than a year of intensive training and education to be classified as a field claims representative. I was, with the training and experience provided to me, a professional claims adjuster and worked as one until four years later when I passed the California Bar and became a licensed attorney.
Today, I’m much older, worked for five years as an adjuster, and 45 more years as an insurance defense lawyer and insurance coverage lawyer. I have, since 2015, worked as an insurance consultant and expert witness, a blogger, and an author on claims handling, insurance coverage and the tort of bad faith.
Becoming a Claims Expert Witness
After 45 years of practicing law a lawyer I knew asked me to be an expert in one of his cases. I had retained many experts in my legal career but this would be my first time testifying to a federal jury with a judge who would have preferred a different case. Although I was frightened on my first attempt I found I was good at explaining insurance and insurance claims handling to a judge and jury. My first attempt – whether because or in spite of my effort – resulted in a verdict in favor of the lawyer client.
In 2015 I was exhausted at operating a law firm and reduced the firm to just me and a computer. I changed my practice as an insurance consultant and expert the only thing I do. My license to practice law is inactive.
Claims experts are retained by lawyers who are litigating an insurance claim dispute after the litigation commences. I am retained by both insurance defense lawyers and policyholder’s lawyers. I have learned that the adjusters who dealt with claims when I did have either retired or died. I now see the work of inexperienced, minimally trained and often incompetent insurance adjusters because their work, or failure to work, were involved in situations that caused the insurer for whom they worked, get sued.
Today I spend most of my time reviewing claims files from counsel litigating insurance claims disputes, write this daily blog, write and update insurance claims books, and testify as an expert witness on behalf of counsel for policyholders and insurers.
Part 2 will deal with the Modern American Claims Adjuster.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Guilty of Money Laundering Scheme
Post 5238
See the video at https://lnkd.in/gqh7V46x and at https://lnkd.in/gmE-zrDC and at https://zalma.com/blog plus more than 5200 posts.
Prison Sentence for Fraud Must be Limited to the Fraud in Which the Defendant Participated
In United States v. Stephen O. Anagor, No. 2:24-CR-00019-DCLC-CRW (E.D. Tenn., Nov. 26, 2025) by Judge Clifton L. Corker the government sought to increase the defendant’s sentence because his co-conspirators added a fraudulent FBI scam that resulted in the victim’s suicide. Anagor sought a lower sentence because he was only involved in part of the fraud.
Charges & Plea
Defendant, a U.S. Army soldier pled guilty on June 11, 2025 to Conspiracy to Commit Mail and Wire Fraud, Aiding and Abetting Aggravated Stalking Resulting in Death and Aiding and Abetting Aggravated Identity Theft that was part of a larger 38-count superseding indictment against Anagor and co-defendants Chinagorom Onwumere and Salma Abdalkareem for an international Nigerian-based ...
Officer Making U-Turn Chasing Criminal May be Immune if Not Done in Reckless Disregard for Safety of Others
Fact Finder Must Establish Basis for Immunity
Post 5236
See the video at https://rumble.com/v72gq5o-governmental-immunity-is-not-absolute.html and at https://youtu.be/CHlEX2ZCc4s and at https://zalma.com/blog plus more than 5200 posts.
In Robert Young v. Officer John Doe et al. No. 2025 CA 0527 (La. App. 1st Cir. November 22, 2025) Robert Young sued Sid J. Gautreaux, III, in his official capacity as Sheriff of East Baton Rouge Parish (the “Sheriff”), and multiple insurance companies. The Sheriff’s Office and an unnamed deputy were not part of the summary-judgment ruling on appeal.
Procedural Posture
The trial court granted Sheriff’s motion for summary judgment, dismissed all claims against the Sheriff with prejudice, holding that La. R.S. 32:24 immunity applied and that Deputy Miller’s conduct did not rise to reckless disregard/gross negligence.
Key Facts
On July 19, 2019, Highway 19 Deputy Kevin ...
ZIFL Volume 29, Issue 23
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Subscribe at https://lnkd.in/gfpn78FM
Read the full article at https://lnkd.in/gczbPSKn and at https://zalma.com/blog plus more than 5200 posts.
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/
Read the full 21 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/11/ZIFL-12-01-2025.pdf
Roofers, Insurance, Hurricanes and Fraud
Homeowners Defrauded by Roofer Litigate for Years to Get Their Money Back
In Gary v. Hollier’s Specialty Roofing, Inc., 23-260 (La. App. 3 Cir. 12/27/23), 389 So. 3d 109 Ryan Gary and Rebecca Gary (the Garys), homeowners who suffered roof damage from Hurricane Delta sued Hollier’s Specialty Roofing, Inc. (Hollier Roofing), a ...
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 ...
Sometimes the Best Court Decision is to Do Nothing
Post 5209
Read the full article at https://www.linkedin.com/pulse/abstention-protects-against-risk-potentially-fact-zalma-esq-cfe-chkzc, and at https://zalma.com/blog plus more than 5200 posts.
In Starr Indemnity & Liability Company v. Scottsdale Insurance Company, No. 24-CV-3309 (PKC) (TAM), United States District Court, E.D. New York (September 30, 2025) the parties C.C.C. and HCC filed actions against Scottsdale in New York state court regarding Scottsdale’s insurance coverage obligations.
FACTS
Underlying Labor Litigation:
Hector David Campoverde sustained injuries from a scaffold fall at a construction site in Brooklyn, New York, on September 14, 2015. Campoverde, an employee of Vazquez Bro Restoration Inc., was working for C.C.C. Renovation Inc., a subcontractor of L&M Builders Group LLC.
LEGAL ISSUES
Declaratory Judgment:
Starr sought a declaratory judgment regarding Scottsdale’s obligations under the 2014-2015 and 2015-2016 policies.
Abstention ...
