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 25, 2025
A Blue Tarp is not a Roof Repair

Roofers, Insurance, Hurricanes and Fraud

Post 5234

See the video at https://rumble.com/v7281fq-a-blue-tarp-is-not-a-roof-repair.html and at https://youtu.be/tgdzky79tG0, and at https://zalma.com/blog plus more than 5200 posts.

Homeowners Defrauded by Roofer Litigates 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 roofing contractor who took the money and refused to complete the repair of the roof.

KEY FACTS

The Garys’ roof was damaged by Hurricane Delta on October 9, 2020. The next day, they signed a written agreement with Hollier Roofing for repairs, including an addendum authorizing direct insurance payments from their insurer, Federal National Insurance Company.

Hollier Roofing installed a temporary tarp and received payments totaling $18,278.21 ($2,190 from the Garys for the tarp, plus insurance checks of $5,588.88 for the tarp and $10,499.33 for repairs). However, no further work was done, and Hollier Roofing submitted escalating estimates ($21,234.04, then $22,406.46) for full roof replacement, leading to an updated insurance approval of $18,224.80.

Frustrated by the lack of progress, the Garys demanded return of unearned funds ($12,689.13) in April 2021. Hollier Roofing partially refunded $6,043.47 but retained $6,645.66, claiming it for overhead, profits, and services under the agreement. The Garys sued in May 2021 for declaratory judgment (invalidating the contract), unjust enrichment, and violations of Louisiana’s Unfair Trade Practices Act (LUTPA).

PROCEDURAL HISTORY

Trial Court Proceedings

On July 2021 the trial took place on declaratory action and Hollier Roofing’s exception of prematurity. March 2022 judgment invalidated the written contract and overruled the exception (unappealed).

April 2022: Hollier Roofing filed an answer and reconventional demand for breach of contract and LUTPA attorney fees. In May 2022 the Garys moved to strike the reconventional demand and for partial summary judgment on unjust enrichment.

In June 2022: Hollier Roofing filed a cross-motion for summary judgment and an amended answer/reconventional demand (without leave for the answer portion). The Garys responded with motions to dismiss the amended pleading, for sanctions, and to compel discovery. On August 19, 2022 the court granted Garys’ motion to strike reconventional demand, partial summary judgment (awarding $6,645.66 for unjust enrichment), and sanctions ($1,500 attorney fees) and concurrently denied Hollier Roofing’s cross-motion for summary judgment.

On August 31, 2022 the court entered a Supplemental Judgment granting the Garys’ motion to compel discovery and denied Hollier Roofing’s motion for leave to amend.

Hollier Roofing appealed both judgments (amended May 15, 2023, for decretal language). Garys answered seeking additional attorney fees.

ISSUES ON APPEAL

The Third Circuit Court of Appeal conducted de novo review for summary judgments and abuse of discretion/manifest error for other issues and held.

Garys’ Partial Summary Judgment was reversed. Garys’ supporting documents (check copies) were unauthenticated (not affidavits/depositions; prior admissions insufficient under La. Code Civ. P. art. 966(D)(2)). Genuine issues of material fact remained on unjust enrichment.

Dismissal of Cross-Motion for Summary Judgment (Affirmed): Untimely served under La. Code Civ. P. arts. 966(B)(1) & 1313(C) (no electronic confirmation of delivery; “Not Read” receipt insufficient).

Denial of Cross-Motion for Summary Judgment was moot. Dismissed as untimely served. Sanctions/Attorney Fees (Reversed): Manifest error under La. Code Civ. P. art. 863; no exceptional circumstances. No bad faith or improper purpose.

Denial of Leave to Amend was affirmed because there was no abuse; evidence showed Hollier Roofing’s pattern of bad faith (delaying tactics, undue prejudice to Garys).

Garys’ Request for Additional Attorney Fees was denied.

DISPOSITION

August 19, 2022 Judgment (as amended) was reversed and dismissed Hollier Roofing’s LUTPA attorney fees claim, Garys’ partial summary judgment, and sanctions/attorney fees was affirmed.

ZALMA OPINION

Hurricanes are hotbeds for fraud perpetrators. The litigation made clear that defendant Hollier Roofing acted horribly to the Garys. They took their money, put a tarp on their roof, and left. Their actions were clearly fraudulent and they deserved judgments against them but had enough money to take the Garys’ through litigation for years from 2020 to 2025 where the opinion finally got a judgment that the Garys can use to get some of their money back if Hollier has funds that can be attached and garnished to the Garys.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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December 12, 2025
$455 Million for Unnecessary Covid Tests is a Crime

Detail Charging Defendant for Fraud is Sufficient
Post 5242

Read the full article at https://lnkd.in/g_HVw36q, see the video at https://lnkd.in/gpBd-XTg and at https://lnkd.in/gzCnBjgQ and at https://zalma.com/blog plus more than 5200 posts.

Charges that Advises the Defendant of the Crime Cannot be Set Aside

In United States Of America v. Lourdes Navarro, AKA Lulu, No. 25-661, United States Court of Appeals, Ninth Circuit (December 4, 2025) Lourdes Navarro appealed the district court’s denial of her motion to dismiss the indictment and enter final judgment was in error.

FACTUAL BACKGROUND

The indictment alleged that insurers reimburse only for medically necessary services. Navarro performed unnecessary respiratory pathogen panel (RPP) tests on nasal swabs collected from asymptomatic individuals for COVID-19 screening.

Navarro billed over $455 million to insurers for those additional RPP tests that she knew to be medically unnecessary. These allegations constituted a plain, concise, and definite written ...

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December 11, 2025
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 ...

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9 hours ago
Zalma’s Insurance Fraud Letter – December 15, 2025

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 ...

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 ...

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