Coverage is Available for Bicycle Rentals not Excluded
Post number 5271
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The Insurance Contract Never Indicated that Coverage was Limited to Activities Specifically Described
In Mollie R. Lerner v. Bela LLC d/b/a The Perch Hotel, et al., CIVIL No. 25-1546 (FAB), United States District Court, D. Puerto Rico (January 21, 2026) Plaintiff Mollie R. Lerner, a North Carolina resident visiting Puerto Rico, rented a bicycle from The Perch Hotel while staying at a nearby Airbnb. While riding the bicycle back, she encountered a steep hill and, upon attempting to brake, was unable to slow down. She lost control, fell over the handlebars, and was subsequently struck by a truck, resulting in serious injuries.
ALLEGATIONS
Lerner alleged that her injuries were caused by the Hotel’s negligence in maintaining...
Subrogation Limited to What Was Paid by Insurer to Insured
Post number 5270
Posted on January 23, 2026 by Barry Zalma
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In Erie Insurance Exchange A/S/O Bates Collision, Inc. James Myers, Anita Morgan, Lossie Auto Service, And Benedictine Sisters Of Erie, Inc. v. United Services Automobile Association v. Bates Collision, Inc., No. 19 WAP 2024, No. J-23-2025, Supreme Court of Pennsylvania (January 21, 2026) Erie attempted to obtain coverage for spoiliation of evidence against the property insurer.
FACTUAL BACKGROUND
On January 22, 2017, a fire broke out at Bates Collision, Inc., resulting in substantial damage to both the facility and several vehicles stored inside. Erie Insurance Exchange, as insurer for Bates and the affected vehicles, paid more than $1.6 million to its insureds under its insurance policy, which allowed Erie to pursue reimbursement for its payments.
Erie, acting as subrogee for Bates and the other insured parties, ...
PIP Fraud Disputes Should Never be Limited to Arbitration
Post number 5269
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In Government Employees Insurance Co. et al v. Active Medical Care, P.C. et al, No. 2:24-cv-10909 (BRM) (JRA), United States District Court, D. New Jersey (January 9, 2026) Defendants moved to Compel Arbitration and Stay the Proceedings (“Motion”). Plaintiffs Government Employees Insurance entities opposed.
Defendants’ Motion to Compel Arbitration and Stay the Proceedings was administratively terminated, and it was further ordered that the parties shall jointly notify the Court as soon as a decision is issued by the New Jersey Supreme Court in the appeal of Allstate New Jersey Insurance Company, et al. v. Carteret Comprehensive Medical Care, P.C., et al. Supreme Court Docket No.: 090337.
ANALYSIS
The central dispute was whether GEICO’s IFPA claims ...
Insurer’s RICO Claim Against Fraudulent Health Insurance Claims Proper
Post number 5268
Read the full article at https://www.linkedin.com/pulse/allstate-works-take-profit-out-crime-fraud-barry-zalma-esq-cfe-xu89c, See the video at and at and at https://zalma.com/blog plus more than 5250 posts.
Allstate Properly Asserted Fraud Claims Against Hospital and Doctors
In Allstate Indemnity Company et al. v. Memorial Heights Emergency Center et al., No. 25-20020 (5th Cir. Jan. 14, 2026) the Plaintiffs, a group of Allstate insurance entities, brought suit against several Defendants who own, manage, and operate Memorial Heights Emergency Center in Houston, Texas to recover monies paid to the listed fraud perpetrators only to have its case dismissed by the trial court and seek reversal at the Fifth Circuit.
FACTUAL BACKGROUND
In 2018, the Defendants entered into agreements with personal injury attorneys to refer ...
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 ...
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 ...
Zalma’s Insurance Fraud Letter
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ZIFL Volume 29, Issue 24
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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 ...
