The Modern Claims Adjuster
Post 5211
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-2-barry-zalma-esq-cfe-ndt5c, see the video at and at https://youtu.be/USx1tFQ9BY4, and at https://zalma.com/blog plus more than 5200 posts.
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.
Adjusters After the Turn of the Century
I don’t see adjusters operating today like I, and my colleagues. were back in the late 1960’s early 1970’s. The basics of claims handling I was taught seemed to be ignored until the states, like California, found it necessary to reiterate the custom and practice I applied when I was an adjuster, with the California Fair Claims ...
The California Fair Claims Settlement Practices Regulations
The Reasons Why the California Department of Insurance Imposed the California Fair Claims Settlement Practices Regulations on All Insurers Doing Business in California
Post 5214
Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-3-barry-zalma-esq-cfe-vmwzc, see the full video at and at and at https://zalma.com/blog plus more than 5200 posts.
In 1993, after delaying for five years after receiving direction from the California Supreme Court, the state of California determined that the insurance industry needed to be regulated to stop insurers from treating the people insured badly and without good faith. It created a set of Regulations called the “California Fair Claims Settlement Practices Regulations” (the “Regulations) that were designed to enforce the mandate created by the California Fair Claims ...
Physician Conspired with Bonavilla to Effect Health Insurance Fraud
Post 5212
Read the full article at https://www.linkedin.com/pulse/conviction-health-insurance-fraud-upheld-barry-zalma-esq-cfe-2hnsc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.
Dennis Davin Bonavilla was involved in an insurance fraud scheme as an executive of Free Choice Healthcare. The scheme targeted indigent patients, often on government-assisted insurance (Medi-Cal/Medicaid), convincing them to switch to group insurance policies obtained by Free Choice. Patients were falsely represented as employees of sham companies (Drexel Group, Kingmakers) to qualify for these policies.
In The People v. Dennis Davin Bonavilla, 081765, California Court of Appeals, Fourth District, Second Division (October 9, 2025) people identified as patients of Bonavilla and Free Choice Healthcare’s patients signed documents (often without ...
The Modern Claims Adjuster
Post 5211
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-2-barry-zalma-esq-cfe-ndt5c, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.
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.
Adjusters After the Turn of the Century
I don’t see adjusters operating today like I, and my colleagues. were back in the late 1960’s early 1970’s. The basics of claims handling I was taught seemed to be ignored until the states, like California, found it necessary to reiterate the custom and practice I applied when I was an adjuster, with the California Fair Claims ...
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 ...
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 ...
