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 08, 2026
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, with an absolute deadline of one year from the date of loss to file a claim.

Greater St. Stephen waited nearly four months after the hurricane to submit its insurance claim. Mt. Hawley investigated and found most evidence of moisture had dissipated, and the engineer concluded that any storm-related damage was minor and repairable, falling below the policy’s deductible. Mt. Hawley denied the claim.

Greater St. Stephen responded by suing.

LEGAL ISSUES

Under New York law, compliance with a notice-of-occurrence provision is a condition precedent to an insurer’s liability.  The court must interpret the facts in the light most favorable to the non-movant but requires the non-movant to produce evidence supporting the essential elements of its claim.

In this case, the insurance contract obligated Greater St. Stephen to give “prompt notice” of loss or damage. The notice obligation is triggered when circumstances known to the insured would suggest to a reasonable person the possibility of a claim.

DISCUSSION

Greater St. Stephen Didn't Give Mt. Hawley Prompt Notice Of The Damage, So Summary Judgment Was Granted To Mt. Hawley

Compliance with a notice-of-occurrence provision in an insurance policy is a condition precedent to an insurer's liability under the policy. Greater St. Stephen didn't submit a formal claim until four months after the hurricane. The notice obligation was triggered when the circumstances known to the insured would have suggested to a reasonable person the possibility of a claim. The clock started running for Greater St. Stephen when it should have known about the possibility of a claim.

Greater St. Stephen conceded that it was made aware of damages to the Property approximately 3-4 days after the Hurricane and hired a public adjuster to scope it out. It argued that the clock shouldn't start then because the property manager was uncertain of the damages. That argument is flatly contradicted by the record. The manager showed up at the property a week or two after the hurricane because he got a call from the tenants about a week earlier telling him that the building was “damaged in the ceiling.”  The manager walked around inside the building and saw leaks. Although he couldn't see if the roof was damaged, when he saw the leaks inside, that's when he said he needed to call a public insurance adjuster who represented Greater St. Stephen, not the insurer. By calling in a public adjuster the manager admitted that there was a “possibility of a claim."

That's the case despite Greater St. Stephen's two arguments to the contrary.

It doesn't matter that Greater St. Stephen may not have understood the full extent of the damages, as it argues.

The standard for when an insured must notify their insurer is not when they learn of the full extent of the damages but is instead when they learn that there is any reasonable possibility of their policy's involvement.
Greater St. Stephen's property manager testified unambiguously about when he was alerted to the damage, and the parties don't disagree about any dates of inspection.

Greater St. Stephen Failed To Give Prompt Notice Once Its Duty To Notify Kicked In

Assuming that Greater St. Stephen knew of the possibility of a claim two weeks after Hurricane Ida, that means that its December notice came around 90 days afterward. By failing to give prompt notice of a loss Greater St. Stephen breached the condition. The court concluded the church failed to comply with the policy’s notice requirement, and summary judgment was granted in favor of Mt. Hawley.

ZALMA OPINION

Public insurance adjusters are insurance professionals who work only for the insured against the insurer. I can only assume that the public insurance adjuster was aware of the conditions of the policy requiring prompt notice and should have done so on behalf of his or her client, Greater St. Stephen to Mt. Hawley. By failing to promptly report the claim was denied and the court affirmed the denial. Greater St. Stephen is not without a remedy, it should seek counsel to determine if an action lies against the public adjuster for failing to make a prompt report after being retained.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:09:19
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ANTI-SLAPP MOTION SUCCEEDS

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Post number 5291

See the video at and at and at https://www.zalma.com/blog plus more than 5250 posts.

The Work of a Court Appointed Receiver is Constitutionally Protected

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In September 2021, the State of California filed felony charges against Simon Semaan, alleging violations of Insurance Code section 11760(a) for making...

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February 19, 2026
Who’s On First – an “Other Insurance Clause” Dispute

When There are Two Different Other Insurance Clauses They Eliminate Each Other and Both Insurers Owe Indemnity Equally

Post number 5289

In Great West Casualty Co. v. Nationwide Agribusiness Insurance Co., and Conserv FS, Inc., and Timothy A. Brennan, as Administrator of the Estate of Pat- rick J. Brennan, deceased, Nos. 24-1258, 24-1259, United States Court of Appeals, Seventh Circuit (February 11, 2026) the USCA was required to resolve a dispute that arose when a tractor-trailer operated by Robert D. Fisher (agent of Deerpass Farms Trucking, LLC-II) was involved in a side-impact collision with an SUV driven by Patrick J. Brennan, resulting in Brennan’s death.

Facts

Deerpass Trucking, an interstate motor carrier, leased the tractor from Deerpass Farms Services, LLC, and hauled cargo for Conserv FS, Inc. under a trailer interchange agreement. The tractor was insured by Great West Casualty Company with a $1 million policy limit, while the trailer was insured by Nationwide Agribusiness Insurance Company with a $2 million ...

00:08:46
February 18, 2026
Win Some and Lose Some

Opiod Producer Seeks Indemnity from CGL Insurers

Post number 5288

Read the full article at https://lnkd.in/guNhStN2, see the full video at https://lnkd.in/gYqkk-n3 and at https://lnkd.in/g8U3ehuc, and at https://zalma.com/blog plus more than 5250 posts.

Insurers Exclude Damages Due to Insured’s Products

In Matthew Dundon, As The Trustee Of The Endo General Unsecured Creditors’ Trust v. ACE Property And Casualty Insurance Company, et al., Civil Action No. 24-4221, United States District Court, E.D. Pennsylvania (February 10, 2026) Matthew Dundon, trustee of the Endo General Unsecured Creditors’ Trust, sued multiple commercial general liability (CGL) insurers for coverage of opioid-related litigation involving Endo International PLC a pharmaceutical manufacturer.

KEY FACTS

Beginning as early as 2014, thousands of opioid suits were filed by governments, third parties, and individuals alleging harms tied to opioid manufacturing and marketing.

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Endo filed Chapter 11 in August 2022; before bankruptcy it ...

00:08:32
February 19, 2026

Passover for Americans
Posted on February 19, 2026 by Barry Zalma
“The Passover Seder For Americans”

For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lost the ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah. Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and wonder how did all these wonderful things come into being. Jews believe the force we call G_d created the entire universe and everything in it. Jews feel G_d is all seeing and knowing and although we can’t see Him, He is everywhere and in everyone.We understand...

February 19, 2026

Passover for Americans

Posted on February 19, 2026 by Barry Zalma

Read the full article at https://www.linkedin.com/pulse/passover-americans-barry-zalma-esq-cfe-5vgkc.

Available at https://www.amazon.com/Passover-Seder-American-Family-Zalma-ebook/dp/B0848NFWZP/ref=tmm_kin_swatch_0?_encoding=UTF8&qid=1584364029&sr=8-4

“The Passover Seder For Americans”

For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lostthe ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah.

Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and ...

January 30, 2026
Anti-Concurrent Cause Exclusion Effective

You Get What You Pay For – Less Coverage Means Lower Premium

Post number 5275

Posted on January 30, 2026 by Barry Zalma

See the video at and at

When Experts for Both Sides Agree That Two Causes Concur to Cause a Wall to Collapse Exclusion Applies

In Lido Hospitality, Inc. v. AIX Specialty Insurance Company, No. 1-24-1465, 2026 IL App (1st) 241465-U, Court of Appeals of Illinois (January 27, 2026) resolved the effect of an anti-concurrent cause exclusion to a loss with more than one cause.

Facts and Background

Lido Hospitality, Inc. operates the Lido Motel in Franklin Park, Illinois. In November 2020, a windstorm caused one of the motel’s brick veneer walls to collapse. At the time, Lido was insured under a policy issued by AIX Specialty Insurance Company which provided coverage for windstorm damage. However, the policy contained an exclusion for any loss or damage directly or indirectly resulting from ...

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