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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November 13, 2025
Court Will Never Interpret Policy to Give Insured Coverage Not Purchased

Insured Refused to Pay Additional Premium for Assault & Battery Coverage
Post 5225

See the video at https://lnkd.in/g-h_eWr6 and at https://lnkd.in/gtcRKMiW, and at https://zalma.com/blog plus more than 5200 posts.

Exclusion for Assault & Battery Enforced

In Golden Bear Insurance Company v. The Levee Bar & Grill, LLC et al., No. 4:24-CV-00764-DGK (W.D. Mo. Nov. 7, 2025) the bar was sued because of an assault and battery by an intoxicated patron and sought defense and indemnity from its insurer. Golden Bear (GB) denied the claim because of an assault and battery exclusion in its policy.

FACTUAL BACKGROUND

Underlying Incident and Lawsuit:

On or about an unspecified date in 2024, Defendant Adrian Hubbard (“Hubbard”), a patron at The Levee, became intoxicated after being overserved alcohol. He was removed from the bar without incident but later engaged in a brief altercation outside, bumping a female security guard. An unknown employee of The Levee (“John Doe”), perceiving a threat to himself or the guard, struck Hubbard in the head, causing him to fall and strike his head on the pavement, resulting in injuries.

Underlying Claims:

Hubbard filed suit against The Levee and John Doe in Jackson County, Missouri Circuit Court on May 20, 2024 (initial petition), alleging negligent overservice of alcohol and removal. An amended petition filed October 3, 2024, added claims of: (1) negligent supervision/training of John Doe (who allegedly had a proclivity for excessive force, which The Levee condoned); and (2) negligence in John Doe’s use of unreasonable force while acting within the scope of employment.

Coverage Denial:

The Levee tendered the claim to GB Insurance on June 26, 2024, and again after the amendment. GB Insurance denied coverage both times, citing the Exclusion.

Insurance Policy:

Plaintiff Golden Bear Insurance Company (“GB Insurance”) issued a Commercial General Liability policy to Defendant The Levee Bar & Grill, LLC (“The Levee”) for the period January 18, 2023, to January 18, 2024. The policy includes an “Assault and Battery Exclusion” (the “Exclusion”) that bars coverage for bodily injury arising from enumerated acts, allegations, or causes of action, including assault and battery. It contains a “Separation of Insureds” provision, treating coverage for each insured separately as if they were the sole insured.

PROCEDURAL HISTORY

GB filed this federal declaratory judgment action under 28 U.S.C. § 2201, seeking a declaration of no duty to defend or indemnify The Levee in the underlying lawsuit due to the Exclusion. The court stayed the underlying action pending resolution.

GB Insurance moved for judgment on the pleadings.

Issues

1 Does the Exclusion preclude coverage for the underlying claims?
2 Is the Exclusion void as against Missouri public policy, which favors self-defense?

ANALYSIS

To succeed on a motion to dismiss the movant must show no material factual issues remain and entitlement to judgment as a matter of law.

Applicability of Exclusion:

Defendants did not contest GB Insurance’s argument that the Exclusion bars coverage for the underlying tort claims (negligent supervision/training and negligence arising from the alleged assault). This constitutes waiver.
Exclusion Not Void Against Public Policy:

Defendants argued the Exclusion violates Missouri’s policy favoring self-defense (citing a carve-out for “reasonable force to protect persons or property”), entitling coverage for John Doe’s alleged defensive act. The court rejected this as “borderline frivolous,” unsupported by caselaw.

Distinction Between Defenses and Coverage:

Self-defense is a valid criminal/civil defense insulating from liability, but it does not mandate insurance coverage for intentional/excluded conduct. These are separate issues.

Contract Interpretation:

Missouri courts will not rewrite policies to create unagreed coverage. The Levee could have purchased optional assault/battery coverage (at extra premium) but did not. Enforcing the Exclusion upholds freedom of contract and is not against public policy.

HOLDING

The motion was granted. GB Insurance had no duty to defend or indemnify The Levee (or any insured) in the underlying lawsuit because the Exclusion applies without material factual dispute. The Exclusion is enforceable.

CONCLUSION

The court declared the Exclusion applies, absolving GB Insurance of defense/indemnity duties.

ZALMA OPINION

Insurance policies limit the risks that the insurer is willing to take. When insuring a bar insurers are usually concerned with the liability of the bar for injuries to third parties due to the intoxication of patrons and the actions of staff to quell disputes between intoxicated persons. GB offered the insured coverage for assault and battery at a higher premium which the insured rejected and opted for the policy with the exclusion and took their chances. When sued the bar attempted to change the policy wording to obtain coverage for which they did not pay a premium only to find itself responsible individually for the costs of defense and indemnity.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:08:29
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STOLI Policy Void for Lack of Insurable Interest

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Post 5227

Read the full article at https://lnkd.in/g8MPwJxM, see the video at https://lnkd.in/gx6rzPH3 and at https://lnkd.in/gumfUqXv, and at https://zalma.com/blog plus more than 5200 posts.

Insurer Needs to be Careful When Retaining an Expert With No Experience About the Key Issue in the Case.
In Ameritas Life Insurance Corp. v. Wilmington Savings Fund Society, FSB, United States District Court for the District of Delaware (Civil Action No. 23-236-GBW), Judge: Gregory B. Williams (November 7, 2025) Ameritas Life Insurance Corp. (“Ameritas”) sought to void a $3 million life insurance policy on the life of Marvin Flaks (the “Policy”) as a stranger-originated life insurance (“STOLI”) policy lacking an insurable interest under Delaware law.
Defendant Wilmington Savings Fund Society, FSB (“Wilmington Savings”), as securities intermediary and counterclaim-plaintiff, opposed and sought to enforce the Policy.
Motion at Issue:

Wilmington Savings’ Daubert ...

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November 13, 2025
No Unjust Enrichment When Insurer Overpays Claim

Policy Terms Control Right to Return of Overpayments

Post 5226

See the video at https://lnkd.in/gxtJVDse and at https://lnkd.in/gGBxEHHH, and at https://zalma.com/blog plus more than 5200 posts.

An Insurer that Claims it Paid More than it Owed Admits to an Incompetent Claims Staff

In Scott A. Saveraid Trust for Scott A. Saveraid Revocable Trust v. QBE Specialty Insurance Company 2:25-cv-394-SPC-DNF, United States District Court for the Middle District of Florida, Fort Myers Division, Judge: Sheri Polster Chappell, U.S. District Judge (Date: November 7, 2025)

Key Facts

The plaintiff, Scott A. Saveraid Trust (the “Trust”), owns real property in Fort Myers Beach, FL. The Trust purchased a homeowners insurance policy (the “Policy”) from defendant QBE Specialty Insurance Company (“QBE”). In September 2022, the property sustained damage from Hurricane Ian, a covered peril under the Policy.

The Trust filed a claim with QBE, which investigated and paid $307,622.32 for dwelling coverage and $20,600 for loss of use. QBE alleges the ...

00:09:59
November 12, 2025
Court Will Never Interpret Policy to Give Insured Coverage Not Purchased

Insured Refused to Pay Additional Premium for Assault & Battery Coverage
Post 5225

See the video at https://lnkd.in/g-h_eWr6 and at https://lnkd.in/gtcRKMiW, and at https://zalma.com/blog plus more than 5200 posts.

Exclusion for Assault & Battery Enforced

In Golden Bear Insurance Company v. The Levee Bar & Grill, LLC et al., No. 4:24-CV-00764-DGK (W.D. Mo. Nov. 7, 2025) the bar was sued because of an assault and battery by an intoxicated patron and sought defense and indemnity from its insurer. Golden Bear (GB) denied the claim because of an assault and battery exclusion in its policy.

FACTUAL BACKGROUND

Underlying Incident and Lawsuit:

On or about an unspecified date in 2024, Defendant Adrian Hubbard (“Hubbard”), a patron at The Levee, became intoxicated after being overserved alcohol. He was removed from the bar without incident but later engaged in a brief altercation outside, bumping a female security guard. An unknown employee of The Levee (“John Doe”), perceiving a threat to himself or the guard, struck Hubbard in the head, ...

00:08:29
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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