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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January 07, 2026
Broker's Failure to Obtain Insurance Ordered Causes Litigation

New Trial Because Jury Used Policy That Provides No Coverage to Assess Damages

Post 5255

Read the full article at https://lnkd.in/drG3xH2R, see the video at https://lnkd.in/d6p8e-9p and at https://lnkd.in/dgPsQ3Sn, and at https://zalma.com/blog plus more than 5250 posts.

In Brown & Brown of Florida, Inc. v. Houligan’s Pub & Club, Inc., and Ormond Wine Company, LLC, Nos. 5D2024-2352, 5D2024-2458, Florida Court of Appeals (January 2, 2026) the Court of Appeals was faced with a case of first impression that involved damages from a hurricane that hit the East Coast of Florida almost a decade ago and the extent to which an insurance broker is responsible for paying for such damages.

The jury entered a verdict in favor of the insurance broker on the insured’s claim that it was negligent in failing to procure insurance, but it found in favor of the insured on claims of breach of fiduciary duty and negligent misrepresentation.

The insurance broker does not contest it breached its duties on these two claims, only whether the damages awarded are proper.

FACTS

Brown & Brown of Florida, Inc., an insurance broker, was engaged by Houligan’s Pub & Club, Inc. and Ormond Wine Company, LLC to procure commercial property insurance for their restaurants in Ormond Beach, Florida. Agent Chris Tolland assured the insureds regarding the coverage he would secure, ultimately procuring only Lloyd’s of London policies. In October 2016, Hurricane Matthew caused significant damage to the properties due to sewage intrusion.

The claims made under the Lloyd’s policy were denied, and a court judgment confirmed no coverage for the damages. Subsequently, Houligan’s and Ormond Wine sued Brown & Brown for negligent failure to procure insurance, breach of fiduciary duty, and negligent misrepresentation. After trial, the jury found for Brown & Brown on the negligent procurement count but against them on the breach of fiduciary duty and negligent misrepresentation claims, allocating 60% negligence to Brown & Brown and 40% to the insureds, resulting in substantial monetary judgments.

LEGAL ISSUES

On appeal, Brown & Brown did not dispute the breach of fiduciary duty or the negligent misrepresentation, but challenged the damages awarded.

The central legal issue was whether the measure of damages and causation for breach of fiduciary duty and negligent misrepresentation claims should be governed by precedent which addressed only negligent procurement of insurance. The trial court correctly declined to apply Brown & Brown’s precedent and relied on established principles that appellate decisions are limited to their facts and holdings.

Breach of fiduciary duty and negligent misrepresentation are potentially broader claims that are not necessarily bound to the existence of a specific insurance policy. Florida law recognizes separate causes of action for breach of fiduciary duty and negligent misrepresentation and holds that each is a distinct theory of recovery.

An insurance agent or broker who agrees or undertakes to procure certain insurance coverage owes his principal a duty to do so within a reasonable time. When the agent fails to do so, even if the agent is not to blame for the failure, he may nevertheless become liable for damages if he fails to inform his principal that the requested insurance has not been procured.

Applying this principle, a reasonable jury could find that even if the insurance the plaintiff wanted was unavailable in the marketplace, the insurance broker should have timely notified the plaintiff so that the plaintiff could consider its alternatives.

Brown & Brown persuasively pointed out that the jury’s damage award was largely based on the Lloyd’s policy, which had been held in the prior declaratory judgment litigation to not provide coverage to Houligan’s or Ormond Wine. That determination was affirmed by this Court.

As such, it was error to allow the jury to calculate damages based on a policy that this Court has said does not provide coverage. Because this error is not harmless, the appropriate remedy was to remand this matter for a retrial limited solely to damages without reliance on the Lloyd’s policy. Pre-judgment interest will also have to be recomputed. The Court of Appeals affirmed the trial court as to all other issues.

ZALMA OPINION

An insurance agent or broker promises to provide the insured with the insurance required. Failure to do so can cause damage to the insured and allows it to sue for damages. In this case it could only sue for damages due to breach of fiduciary duty and negligent misrepresentation. The trial court erred in allowing the jury to set damages based on a policy that provided no coverage to the insureds instead of limiting them to breach of fiduciary duty and/or negligent misrepresentation. New trial only on damages.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:08:01
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4 hours ago
Public Adjuster Immediately Retained but Insurer Not Notified

Insured Must Give Prompt Notice of Loss
Post 5256

Read the full article at https://lnkd.in/gBXRbKXD, see the video at https://lnkd.in/g4DKfUDz and at https://lnkd.in/g65V_RQ7 and at https://zalma.com/blog plus more than 5250 posts.

Once The Insured Knows There is Damage It is Obligated to Report the Loss to the Insurer

In Greater St. Stephen Ministries, Inc. v. Mt. Hawley Insurance Company, No. 24-cv-3130 (AS), United States District Court, S.D. New York (January 2, 2026) resolved a case brought by a church against an insurance company for denying coverage after Hurricane Ida. After discovery, the insurance company moved for summary judgment because it claimed the insured breached a material condition of the policy.

BACKGROUND

Greater St. Stephen Ministries, Inc., a church located in Louisiana, owned property that suffered damage from Hurricane Ida on August 29, 2021. The property was insured under a policy with Mt. Hawley Insurance Company, which required the insured to provide “prompt notice” of any loss or damage, ...

00:09:19
4 hours ago
Public Adjuster Immediately Retained but Insurer Not Notified

Insured Must Give Prompt Notice of Loss
Post 5256

Read the full article at https://lnkd.in/gBXRbKXD, see the video at https://lnkd.in/g4DKfUDz and at https://lnkd.in/g65V_RQ7 and at https://zalma.com/blog plus more than 5250 posts.

Once The Insured Knows There is Damage It is Obligated to Report the Loss to the Insurer

In Greater St. Stephen Ministries, Inc. v. Mt. Hawley Insurance Company, No. 24-cv-3130 (AS), United States District Court, S.D. New York (January 2, 2026) resolved a case brought by a church against an insurance company for denying coverage after Hurricane Ida. After discovery, the insurance company moved for summary judgment because it claimed the insured breached a material condition of the policy.

BACKGROUND

Greater St. Stephen Ministries, Inc., a church located in Louisiana, owned property that suffered damage from Hurricane Ida on August 29, 2021. The property was insured under a policy with Mt. Hawley Insurance Company, which required the insured to provide “prompt notice” of any loss or damage, ...

00:09:19
January 06, 2026
Insurance Agent Has No Right to Keep Insurer’s Money

Agent Loses License for Misappropriating Insurers Funds
Post 5254

See the video at https://lnkd.in/gPpkx-np and at https://lnkd.in/g7AidnXS, and at https://zalma.com/blog plus more than 5250 posts.

Insurance Agent Fraud Fails

In Rochell Provost v. State Of Louisiana Division Of Administrative Law And Louisiana Department Of Insurance, No. 2025 CA 0492, Court of Appeals of Louisiana, First Circuit (December 19, 2025) the Louisiana Department of Insurance (LDI) successfully appealed a district court judgment that reinstated Rochell Provost’s insurance producer license and reversed a $5,000 fine previously assessed against her.
FACTUAL BACKGROUND

The underlying dispute began when Union National Life Insurance Company/Kemper Life terminated Ms. Provost for cause, alleging she had committed fraudulent activity and misappropriated $31,471.39 in company funds. An investigative report supporting these findings was sent to LDI.

Following receipt of the report, LDI notified Ms. Provost of proposed regulatory action concerning ...

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December 31, 2025
“Sudden” is the Opposite of “Gradual”

Court Must Follow Judicial Precedent
Post 5252

Read the full article at https://www.linkedin.com/pulse/sudden-opposite-gradual-barry-zalma-esq-cfe-h7qmc, see the video at and at and at https://zalma.com/blog plus more than 5250 posts.

Insurance Policy Interpretation Requires Application of the Judicial Construction Doctrine

In Montrose Chemical Corporation Of California v. The Superior Court Of Los Angeles County, Canadian Universal Insurance Company, Inc., et al., B335073, Court of Appeal, 337 Cal.Rptr.3d 222 (9/30/2025) the Court of Appeal refused to allow extrinsic evidence to interpret the word “sudden” in qualified pollution exclusions (QPEs) as including gradual but unexpected pollution. The court held that, under controlling California appellate precedent, the term “sudden” in these standard-form exclusions unambiguously includes a temporal element (abruptness) and cannot reasonably be construed to mean ...

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December 29, 2025
Doctor Accused of Insurance Fraud Sues Insurer Who Accused Him

Lack of Jurisdiction Defeats Suit for Defamation

Post 5250

Posted on December 29, 2025 by Barry Zalma

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He Who Represents Himself in a Lawsuit has a Fool for a Client

In Pankaj Merchia v. United Healthcare Services, Inc., Civil Action No. 24-2700 (RC), United States District Court, District of Columbia (December 22, 2025)

FACTUAL BACKGROUND
Parties & Claims:

The plaintiff, Pankaj Merchia, is a physician, scientist, engineer, and entrepreneur, proceeding pro se. Merchia sued United Healthcare Services, Inc., a Minnesota-based medical insurance company, for defamation and related claims. The core allegation is that United Healthcare falsely accused Merchia of healthcare fraud, which led to his indictment and arrest in Massachusetts, causing reputational and business harm in the District of Columbia and nationwide.

Underlying Events:

The alleged defamation occurred when United ...

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December 15, 2025
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 ...

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