Neither Defense nor Indemnity Available Because of Exclusion
Post number 5293
See the video at and at https://youtu.be/iORBwITjMhE, and at https://zalma.com/blog plus more than 5250 posts.
You’re reading from the free part of Excellence in Claims Handling. You should consider joining as a paid member to get full access to articles for members only, to our news, analysis, insurance coverage, claims, insurance fraud and insurance webinars, by clicking at the “subscribe” button above.
Security at Low Income Housing to Risky for Insurer
In Everest Indemnity Insurance Company v. Kates Detective & Security Services Agency, Inc., et al., No. 25 C 5488, United States District Court, N.D. Illinois, Eastern Division (February 18, 2026) dealt with a clear and unambiguous exclusion.
Facts
Everest Indemnity Insurance Company sued Kates Detective & Security Services Agency, Inc. and the Chicago Housing Authority (CHA) seeking a ...
Fraud Perpetrators Have no Honor
Post number 5294
See the video at and at and at https://zalma.com/blog plus more than 5250 posts.
First Circuit Affirms Sentence
In United States Of America v. Chang Goo Yoon, No. 24-1520, United States Court of Appeals, First Circuit (February 20, 2026) Chang Goo Yoon, a licensed physical therapist operating clinics in Massachusetts, engaged in a fraudulent scheme between November 2014 and November 2018. He submitted over a million dollars in false health insurance claims to private insurers, including Blue Cross Blue Shield and Aetna, as well as personal injury claims to MAPFRE, his own car insurer.
Facts
Yoon fabricated treatment notes, billed for services never rendered, and used his office address as patients’ addresses to ensure reimbursement checks were sent directly to him. This arrangement prevented patients from receiving paperwork for services they did not...
Fraud Perpetrators Have no Honor
Post number 5294
See the video at and at and at https://zalma.com/blog plus more than 5250 posts.
First Circuit Affirms Sentence
In United States Of America v. Chang Goo Yoon, No. 24-1520, United States Court of Appeals, First Circuit (February 20, 2026) Chang Goo Yoon, a licensed physical therapist operating clinics in Massachusetts, engaged in a fraudulent scheme between November 2014 and November 2018. He submitted over a million dollars in false health insurance claims to private insurers, including Blue Cross Blue Shield and Aetna, as well as personal injury claims to MAPFRE, his own car insurer.
Facts
Yoon fabricated treatment notes, billed for services never rendered, and used his office address as patients’ addresses to ensure reimbursement checks were sent directly to him. This arrangement prevented patients from receiving paperwork for services they did not...
Bad Faith Suit Requires Specificity About What Was Unfair
Pro Se Plaintiff Needed a Lawyer
Post number 5292
See the video at https://lnkd.in/gEZFNq38 and at https://lnkd.in/gZXMPDRb, and at https://zalma.com/blog plus more than 5250.
In Sean Shurelds v. SAFECO Insurance Company of America, a/k/a Liberty Mutual, Civil Action No. 25-cv-1550, United States District Court, E.D. Pennsylvania (February 11, 2026) Plaintiff Sean Shurelds, acting pro se, filed suit against Safeco Insurance Company of America alleging bad faith insurance practices, fraudulent misrepresentation, and negligence with the USDC giving him several attempts to sufficiently allege facts to state a cause against SAFECO.
Shurelds had purchased a landlord protection policy for his Philadelphia property, which was in effect from November 28, 2023, to November 28, 2024. After his tenant abandoned the property and unauthorized occupants caused extensive damage, Shurelds submitted five insurance claims to Safeco. Safeco denied all of these claims, citing the ...
Contract Breaches that Allow Multiple Different Grounds to Make a Policy Void
More from Excellence in Claims Handling Substack for Subscribers Only. You can Subscribe to my substack at https://barryzalma.substack.com/subscribe
Posted on February 24, 2026 by Barry Zalma
You’re reading from the free part of Excellence in Claims Handling until you reach the paywall. You should consider joining as a paid member to get full access to articles for members only, to our news, analysis, insurance coverage, claims, insurance fraud and insurance webinars, by clicking at the “subscribe” link below.
If an insured breaches one or more material warranties and increases the risk covered by the policy, the contract may be voided by the insurer, depending on the jurisdiction. It is, therefore, essential that every claims investigation include efforts to establish compliance with every warranty.
In Cummings v. Fire Insurance Exchange, 292 Cal. App. 3d 1407, 249 Cal. Rptr. 568 (1988), the Court of Appeal ...
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...
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.
“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 ...
