Not All Expert Testimony must be Scientifically Reliable
Post number 5284
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In Church Mutual Insurance Company, S.I. v. Chabad Of New Mexico, No. 1:24-cv-00090-MIS-SCY, United States District Court, D. New Mexico (February 10, 2026) the USDC dealt with a declaratory judgment filed by Church Mutual that it owes no duty to cover Chabad’s claims because the property was “vacant” for more than sixty consecutive days before the acts of arson, and therefore no coverage is owed pursuant to the Policy’s “Vacancy” loss condition.
FACTUAL BACKGROUND
Church Mutual Insurance Company, S.I. (“Church Mutual”) renewed an insurance policy for Chabad of New Mexico (“Chabad”) covering real property in Rio Rancho, New Mexico. The policy included a “Vacancy” loss condition, stating that if the building was vacant for more than 60 consecutive days prior to a loss, Church Mutual would not pay for losses caused by certain events, including vandalism.
The claims adjuster assigned to investigate the fires stated that “while the building was not actively being used, there remained sufficient contents in the structure for the Insured to continue their normal operations.”
The interpretation and construction of an insurance policy is a question of law for the Court and one that the Court performed when it ruled on the Parties’ cross-motions for summary judgment on the issue of coverage concluding that Chabad’s building was not “vacant” under the unambiguous terms of the Policy and that therefore Chabad was entitled to summary judgment on the issue of coverage as to both fires. As such, the Court finds that this argument was moot.
Chabad sought to introduce expert testimony regarding insurance industry standards, customs and practices and about how Church Mutual Insurance Company deviated from those standards in its handling of the property damage claims of” Chabad. Chabad hired Stuart Setcavage who purports to be “an expert in the field of insurance industry claim handling, policy interpretation and coverage analysis.”
As to the Vacancy provision, Mr. Setcavage states: “Claim professionals are trained to know that the vacancy condition of the building combines suspension of coverage for certain perils with reduction in coverage for others . . . The approach . . . eliminates coverage only for the perils most affected by vacancy, and it reduces coverage for damage by other perils. ”
Church Mutual sought to exclude the expert testimony of S. Setcavage.
ANALYSIS/DISCUSSION:
The Court denied Church Mutual’s Corrected Motion to Exclude the testimony of S. Setcavage. The judge found that the motion did not warrant exclusion and permitted the testimony to be presented at trial.
Mr. Setcavage noted that “neither the perils of arson nor fire are specifically identified” in the Vacancy provision, and opines that “the intent of the policy was to reduce coverage by 15% for perils not specifically listed, not eliminate it altogether.” Mr. Setcavage further opined that Church Mutual is attempting to redefine ‘vacancy’ to include factors not set forth in the policy. Church Mutual now wants vacant to mean unused.
District courts evaluating the reliability of non-scientific expert testimony do not have to focus on whether the expert employed an objective standard or methodology and can instead focus on the reliability of the expert’s personal knowledge or experience.
Here, Mr. Setcavage has offered opinions that may assist the jury in deciding whether Church Mutual has engaged in bad faith insurance conduct. In fact, the claim handling or investigation is indicia of a pre-determination to deny payment for these claims. The Court was satisfied that Mr. Setcavage’s proposed expert testimony was both reliable and relevant, in that it will assist the trier of fact.
Church Mutual Insurance Company’s Corrected Motion to Exclude the Testimony of S. Setcavage, was denied.
ZALMA OPINION
Insurance claims handling expert witnesses are not scientists, do not deal with scientific or engineering realities but rather are presented to explain to a jury that actions of an insurer in dealing with a claim, were conducted within the custom and practice of the insurance industry and whether the insurer fulfilled or failed to fulfill the standards of the industry. For that reason, since the court had ruled that the insurer’s attempt to apply a vacancy condition to apply to perils not identified the court concluded the expert would help the jury understand whether the tort of bad faith was involved.
(c) 2026 Barry Zalma & ClaimSchool, Inc.
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The Right to Negotiate with Insurer is Not an Assignment of Claims
Post number 5347
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Nebraska Requires an Actual Assignment to Allow Contractor to Sue Insurer
In Millard Gutter Company, a corporation doing business as Millard Roofing and Gutter v. Farmers Mutual Insurance Company of Nebraska, also known as Farmers Mutual Insurance, also known as Farmers Mutual, No. A-24-818, Court of Appeals of Nebraska (May 5, 2026) Millard sued Farmers as an assignee of Jane Anzalone who had hired Millard Gutter to repair the roof of her home and agreed to allow Millard Gutter to coordinate with her insurer, Farmers Mutual, concerning reimbursement for repairs authorized under her insurance policy.
FACTUAL BACKGROUND
In ...
Attempt to Withdraw Plea After Sentencing Fails
Post number 5346
Read the full article at https://www.linkedin.com/pulse/admit-crime-ready-do-time-barry-zalma-esq-cfe-hgyce, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
Stealing from Insurers and Employer Gets Defendant Five Years in Prison
In State of Wisconsin v. Jacquelyn R. Harris, No. 2025AP489-CR, Court of Appeals of Wisconsin (April 22, 2026) Harris pled no contest and was found guilty. She was sentenced to five years of initial confinement and three years of extended supervision, with restitution ordered in the amounts of $31,086 to Kaliber and $25,000 to Erie Insurance Company.
FACTUAL BACKGROUND
In late 2022, Jacquelyn R. Harris was charged with theft in a business setting under WIS. STAT. § 943.20(1)(b) (2023-24). Harris, while employed as the office manager for Kaliber Collision Repair in Port ...
Attempt to Withdraw Plea After Sentencing Fails
Post number 5346
Read the full article at https://www.linkedin.com/pulse/admit-crime-ready-do-time-barry-zalma-esq-cfe-hgyce, see the video at https://rumble.com/v79hhg6-admit-to-crime-and-be-ready-to-do-the-time.html and at and at https://zalma.com/blog plus more than 5300 posts.
Stealing from Insurers and Employer Gets Defendant Five Years in Prison
In State of Wisconsin v. Jacquelyn R. Harris, No. 2025AP489-CR, Court of Appeals of Wisconsin (April 22, 2026) Harris pled no contest and was found guilty. She was sentenced to five years of initial confinement and three years of extended supervision, with restitution ordered in the amounts of $31,086 to Kaliber and $25,000 to Erie Insurance Company.
FACTUAL BACKGROUND
In late 2022, Jacquelyn R. Harris was charged with theft in a business setting under WIS. STAT. § 943.20(1)(b) (2023-24). Harris, while employed as the office manager for Kaliber Collision Repair in Port ...
It is Fraud to Make the Same Claim Twice
Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.
Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages
Post number 5347
No One is Entitled to be Paid for the Same Loss Twice
In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.
BACKGROUND
In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.
PROCEDURAL HISTORY
State Farm filed motion for summary...
It is Fraud to Make the Same Claim Twice
Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.
Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages
Post number 5347
No One is Entitled to be Paid for the Same Loss Twice
In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.
BACKGROUND
In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.
PROCEDURAL HISTORY
State Farm filed motion for summary...
What Must be Done after Notice of a Claim is Received by the Insurer
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A first party property policy does not insure property: it insures a person, partnership, corporation or other entity against the risk of loss of the property. Before an insured can make a claim for indemnity under a policy of first party property insurance the insured must prove that there was damage to property the risk of loss of which was insured by the policy. The obligation imposed on the insured ...