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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February 09, 2026
To Be Insured You Must be Named and Live in House

Owner of Property Not Named as Insured Has No Standing

Post number 5280

See the video at https://lnkd.in/gVwMZnES and at https://lnkd.in/geUWJ5Sa, and at https://zalma.com/blog plus more than 5250 posts.

When Ownership in Property Changes it is Essential to Cause the Policy to Name the New Owner as Insured

In Joyce Lynn Serauskas v. Liberty Mutual Fire Insurance Co., No. 25-cv-12474, United States District Court, N.D. Illinois, Eastern Division (February 4, 2026) in August 2024 a fire damaged a home on West 51st Street in Chicago. Joyce Lynn Serauskas filed an insurance claim with Liberty Mutual Fire Insurance Co., under a homeowner’s policy originally issued to her mother, Estelle Bielecki, in 1978.

FACTUAL BACKGROUND

The policy had been automatically renewed every year with premiums paid on time, including at the time of the fire. However, Estelle Bielecki had passed away in 2010, and Serauskas had continued to reside in the home and pay premiums.

Eventually Serauskas acquired full ownership before the fire.

LEGAL ISSUES

Serauskas brought claims for breach of contract and for vexatious and unreasonable conduct under § 155 of the Illinois Insurance Code. She also asserted estoppel and equitable lien claims, arguing Liberty Mutual created a reasonable expectation of coverage by accepting premiums and issuing renewals after Estelle’s death. Liberty Mutual moved to dismiss, challenging standing and the sufficiency of Serauskas’s claims under Federal Rules of Civil Procedure 12(b)(1) and 12(b)(6).

DISCUSSION AND ANALYSIS

The policy was issued to her deceased mother but Serauskas had paid premiums and lived at the property for years. Standing implicates the court’s subject-matter jurisdiction. Rule 12(b)(6) examines the legal sufficiency of the claims, requiring that factual allegations plausibly suggest the existence of jurisdiction and a viable claim. The court noted that standing is a fundamental requirement under Article III, focusing on whether the litigant is entitled to have the court decide the merits of the dispute.

The court granted Liberty Mutual’s motion to dismiss, though some claims were dismissed without prejudice, suggesting potential for refiling if properly pleaded. The analysis centered on whether Serauskas, as someone who paid premiums and ultimately owned the property, could enforce the policy issued in her mother’s name and whether Liberty Mutual’s conduct created a reasonable expectation of coverage despite the named insured’s death.

Liberty Mutual argued that the breach of contract claim must be dismissed because Serauskas lacks standing-she is not a party to the insurance contract and therefore cannot sue for breach.

A nonparty’s right to enforce a contract is governed by state law. There is no dispute that Estelle Bielecki is the “named insured” and the home on West 51st Street is the relevant Property described in the Policy. Because she is not a named insured, Liberty Mutual argued that Serauskas lacks standing to sue. It also notes that although the Policy contains an assignment provision, at no time prior to the fire in 2024 did Liberty Mutual provide written consent for assignment of the policy.

Serauskas’s arguments in response are non-starters.

The issue is not whether Serauskas was required under the Policy to notify Liberty Mutual of her mother’s death. It’s whether she qualified under the relevant provision of the Policy as a named insured. She did not.

The motion to dismiss was granted.

ZALMA OPINION

Ms. Serauskas was ignorant of the insurance issues raised by her mother’s death. First, a homeowners policy requires the named insured to reside in the premises for insurance to apply. In addition, only an insured, as defined by the policy, can recover as a result of a loss, like a fire. Serauskas was not an insured but resided in the premises. The named insured was dead and could not reside in the premises. To avoid the problem all that Serauskas’ needed to do was amend the policy to name her as an insured. She did not do so, was not an insured, and had no rights under the policy and the person with those rights was dead.

(c) 2026 Barry Zalma & ClaimSchool, Inc.

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00:08:14
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September 18, 2026
Expert May Only Testify to What Experience Supports

Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.

Posted on September 18, 2026 by Barry Zalma

See the full video at and at https://rumble.com/v7fmifw-expert-may-only-testify-to-what-experience-supports.html

In Michele A. Over, and The Estate Of Paul R. Over v. State Farm Mutual Automobile Insurance Company, and State Farm Fire And Casualty Company, Civil Action No. 23-cv-02243-PAB-STV, United States District Court, D. Colorado (September 14, 2026) Michele and Paul Over sued State Farm Fire and State Farm Auto over hail-damage and stolen-vehicle claims.

The operative dispute concerned State Farm Auto’s motion to exclude or limit opinions from plaintiffs’ insurance-industry expert, Aaron Castillo. Castillo.

Law

The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...

00:03:10
September 17, 2026
Convicted on 29 Tax-Refund-Fraud Counts

150 Months in Prison for Tax Fraud
Post 4846

Posted on September 17, 2026 by Barry Zalma

See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.

FACTS

In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS

Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.

The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...

00:05:23
September 14, 2026
Court Enforces Fifth Amendment & Refuses to Compel Answers

Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution

Post 5489

Posted on September 14, 2026 by Barry Zalma

Fraudster Refuses to Answer Questions About His Alleged Fraud

See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr

In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.

Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.

After Great American ...

00:05:14
3 hours ago
Suit Must be Ripe When Filed

A Suit Filed Before the Claim Exists is Fatal

Post 4870

Posted on October 20, 2026 by Barry Zalma

In Louis Briggs v. Shaun Wimberly; Somerset Services, Inc.; And Wimberly & Associates, PLLC, and Louis Briggs v. Shaun Wimberly And Wimberly & Associates, PLLC Nos. 2024-CA-1471-MR, 2025-CA-1366-MR, Court of Appeals of Kentucky (October 9, 2026) Louis Briggs was arrested in 2014 after an incident with police and charged with several offenses, including third-degree assault.

Probable cause was found and an indictment was returned, but the charges were eventually dismissed. His attorney, Shaun Wimberly, then filed a federal civil rights suit for Briggs in a United States district court, which also asserted state-law claims. The district court dismissed most of the claims and declined to exercise jurisdiction over the remaining state-law claims. Briggs blamed Wimberly for the result, fired him, and appealed to the Sixth Circuit.

While the federal appeal was pending, Briggs filed a legal malpractice action against Wimberly in the Jefferson Circuit Court. The Sixth ...

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October 19, 2026
Plaintiff’s Reading of the Policy is Plaintiff’s Reasonable Allegations Posted on October 19, 2026 by Barry Zalma CLASS ACTION THAT STATES A SIMPLE CLEAR AND PLAUSIBLE CAUSE OF ACTION SURVIVES Post 4868 In Sheila Marino v. Farmers New World Life Insura

Plaintiff’s Reading of the Policy is Plaintiff’s Reasonable Allegations

Posted on October 19, 2026 by Barry Zalma

Post 4868

CLASS ACTION THAT STATES A SIMPLE CLEAR AND PLAUSIBLE CAUSE OF ACTION SURVIVES

In Sheila Marino v. Farmers New World Life Insurance Company, No. 2:25-cv-02200-JNW, United States District Court, W.D. Washington, Seattle (October 13, 2026) defendant Farmers New World Life Insurance Company’s (“FNWL”) moved to dismiss Plaintiff Sheila Marino’s putative class action involving flexible universal life insurance.

Marino filed a putative class action in King County Superior Court alleging: (1) breach of contract, (2) breach of the implied covenant of good faith and fair dealing, and (3) violation of the Washington Consumer Protection Act (CPA).

She pleaded two theories: an “overcharge” theory and an “underpayment of interest” theory asked the Court to take judicial notice of historical Federal Funds Effective Rates.

THE LAW

Pleading Standard.

To survive a Rule 12(b)(6) motion, a ...

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October 16, 2026

Alleged Defamatory Statements Must be Of and Concerning Plaintiffs

Posted on October 16, 2026 by Barry Zalma

To Prove Defamation the Statement Must be Of and Concerning the Plaintiffs

Post 4867

In Michael Moloney and Sergio Cantu v. United Services Automobile Association, No. 04-25-00519-CV, Court of Appeals of Texas, Fourth District, San Antonio (October 14, 2026) Michael Moloney and Sergio Cantu appealed from the trial court’s granting of a traditional motion for summary judgment in favor of United Services Automobile Association (“USAA”) on their defamation claim.
BACKGROUND

Moloney and Cantu sued USAA for defamation, alleging that they are the principals of Informed Roofing & Restoration, LLC (“Informed Roofing”), which is primarily engaged in the residential roofing repair and replacement business, and that an employee or agent of USAA had made false and defamatory statements to the San Antonio Police Department (“SAPD”) concerning them.

Specifically, Moloney and Cantu alleged that an employee of ...

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