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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March 31, 2026
When Genuine Disputes of Material Fact Exist Summary Judgement Fails

Material Fact Not Proved Defeats Summary Judgment
Post number 5314

See the full video at https://lnkd.in/guT-87b6 and at https://lnkd.in/gEQrFndb and at https://zalma.com/blog, plus more than 5300 posts.

In Peleus Insurance Company, on its own behalf and on behalf of Bais Yaakov Dkal Adas Yereim and BT General Builders, Inc. v. United Specialty Insurance Company, No. 24 Civ. 1398 (KPF), United States District Court, S.D. New York (March 23, 2026) Peleus Insurance Company (“Peleus”), on behalf of itself and insureds Bais Yaakov Dkal Adas Yereim (“Bais”) and BT General Builders, Inc. (“BT”), initiated an action against United Specialty Insurance Company (“USIC”) in the United States District Court for the Southern District of New York. Peleus sought declaratory judgment regarding USIC’s obligations to defend and indemnify its insureds in connection with an underlying personal injury lawsuit pending in the Supreme Court of the State of New York, Kings County. Both parties cross-moved for summary judgment concerning USIC’s duty to defend.

FACTUAL BACKGROUND

The underlying action arose from an accident at a construction site located at 184-198 Nostrand Avenue, Brooklyn, New York, where Jonathan Caceres, employed by Charles Contractors Corp., sustained injuries while carrying a stone slab up a staircase. Caceres sued BT and Bais in state court, alleging negligence and violations of New York Labor Law Sections 200, 240, and 241(6). At the time of the accident, Charles Contractors was engaged in stonework at the site. Caceres’s injuries occurred when he slipped on water, lost control of the slab, and the slab fell on his left foot.

LEGAL STANDARDS

The motions for summary judgment required the court to determine whether USIC owed a duty to defend and indemnify BT and Bais as “additional insureds” under USIC-issued policies. The duty to defend is typically broader than the duty to indemnify and hinges on the terms of the insurance policy and the allegations in the underlying complaint.

COURT’S ANALYSIS AND DISCUSSION

The court’s analysis centered on the timing and validity of the agreement purportedly extending additional insured coverage to BT and Bais under USIC’s policies. Both parties argued for summary judgment on USIC’s duty to defend, but the court found a material dispute regarding whether the relevant agreement was executed before the accident occurred. This factual uncertainty precluded a definitive ruling on coverage and defense obligations. The court concluded that, due to unresolved factual questions concerning the execution date of the agreement, neither party was entitled to summary judgment.

CONCLUSION

The court denied both Peleus’s and USIC’s motions for summary judgment. The outcome preserves the need for further proceedings to resolve the disputed facts, particularly regarding the timing of the agreement that could trigger USIC’s duty to defend and indemnify.

Insurance policies are, in essence, creatures of contract, and, accordingly, subject to principles of contract interpretation. The initial interpretation of a contract is a matter of law for the court to decide.
Genuine Disputes of Material Fact Exist Concerning the Execution Date of the Sandstone Agreement

The parties do not seriously dispute that, if the Court finds that BT and Bais qualify as additional insureds under the USIC Policy, USIC would have a duty to defend them in the Underlying Action. Instead, the parties dispute the antecedent question of whether BT and Bais qualify as additional insureds under the USIC Policy.

In point of fact, these recitals do not mean that the Sandstone Agreement was executed on April 20, 2022, prior to Mr. Caceres’s alleged Accident. The evidence concerning the execution date of the Sandstone Agreement raises genuine disputes of material fact. In short, Peleus has not proved, nor has USIC disproved, that BT and Bais qualify as additional insureds under the USIC Policy for two separate reasons, one temporal and one intent-based. In the absence of a more developed factual record, resolution of that issue will have to wait until trial.

The decision underscores the importance of clear documentation and timing in additional insured coverage disputes and serves as a reminder that summary judgment is inappropriate when material facts remain contested.

ZALMA OPINION

Additional insured endorsements are important to every insured doing business where the contract requires them to make others insureds on the named insured’s policy. They are prevalent in construction contracts where the general contractor and owner try to shift the risk of loss to the subcontractors policies. In this case, the contract promising to make another an additional insured was not signed until after the accident and summary judgment was not proper.

(c) 2026 Barry Zalma & ClaimSchool, Inc.

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00:06:42
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May 26, 2026
He Who Acts as His Own Lawyer Has an Idiot for a Client

Arsonist Tried To Represent Himself, Failed, and Sought Habeas Relief

Post number 5357

Read the full article at https://www.linkedin.com/pulse/he-who-acts-his-own-lawyer-has-idiot-client-barry-zalma-esq-cfe-d4bwc, See the full video at and at and at https://zalma.com/blog.

Karacson’s Arson for Profit Attempt Required Skill & Experience to Succeed

In Steve Ellis Karacson v. David Shaver, Warden, No. 25-1089, United States Court of Appeals, Sixth Circuit (May 20, 2026) Steve Karacson was convicted in Michigan state court of arson and insurance fraud after evidence showed he burned his own insured home. Investigators found multiple points of origin, gasoline odor, and evidence tying him to the scene, including cell-phone location data and a receipt showing he had purchased a gas can and gloves shortly before the fire.

FACTS

Karacson initially had appointed counsel, but his relationships with both appointed attorneys ...

00:08:55
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May 11, 2026
Severe Punishment for Failure to Obey Court Orders

Foolish to Repeatedly Disobey Court Orders

All That Remains For Trial Is Plaintiff’s Damages On Each Of These Claims And Establishing Proximate Causation Of Those Damages.

Post number 5348

See the full video at and at and at https://zalma.com/blog plus 5300 posts.

In Linh Wang v. Esurance Insurance Company, No. C24-0447-JCC, United States District Court, W.D. Washington, Seattle (May 1, 2026) John C. Coughenour, United States District Judge, found that throughout this case, culminating with its briefing on Plaintiff’s renewed motion and that Defendant has subjected Plaintiff to unnecessary motion practice for clearly discoverable information and made dubious representations (including to the Court).

FACTUAL BACKGROUND

This case involves an underinsured/uninsured motorist insurance bad faith claim arising from a 2017 motor vehicle collision. The plaintiff, Linh Wang, alleges that Esurance Insurance ...

00:08:27
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May 08, 2026
Ambiguous Contract to Repair not an Assignment

The Right to Negotiate with Insurer is Not an Assignment of Claims

Post number 5347

Read the full article at https://www.linkedin.com/pulse/ambiguous-contract-repair-assignment-barry-zalma-esq-cfe-2xppc, see the full video at https://rumble.com/v79is1s-ambiguous-contract-to-repair-not-an-assignment.html and at and at https://zalma.com/blog plus more than 5300 posts.

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 ...

00:08:02
19 hours ago
Zalma’s Insurance Fraud Letter – June 15, 2026

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

Posted on June 15, 2026 by Barry Zalma

ZIFL – Volume 30, Issue 12

June 15, 2026

Post number 5372

Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th 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/ This issue contains the following articles about insurance fraud:

Go to Jail, Do Not Pass Go

Arsonist Who Tried to Defraud Insurer Failed to Avoid Jail

Arson is a Violent and Dangerous Crime Deserving Serious Punishment

The People of the State of New York v. Zef Gjurashaj, 2026 NY Slip Op 03320, No. 2023-03675, Ind. No. 70463/21, Supreme Court of New York, Second Department (May 27, 2026) the defendant owned a restaurant that was destroyed by fire on September 6, 2017. Prosecutors alleged that he and a codefendant conspired to intentionally set the fire in order ...

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19 hours ago
Zalma’s Insurance Fraud Letter – June 15, 2026

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

Posted on June 15, 2026 by Barry Zalma

ZIFL – Volume 30, Issue 12

June 15, 2026

Post number 5372

Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th 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/ This issue contains the following articles about insurance fraud:

Go to Jail, Do Not Pass Go

Arsonist Who Tried to Defraud Insurer Failed to Avoid Jail

Arson is a Violent and Dangerous Crime Deserving Serious Punishment

The People of the State of New York v. Zef Gjurashaj, 2026 NY Slip Op 03320, No. 2023-03675, Ind. No. 70463/21, Supreme Court of New York, Second Department (May 27, 2026) the defendant owned a restaurant that was destroyed by fire on September 6, 2017. Prosecutors alleged that he and a codefendant conspired to intentionally set the fire in order ...

post photo preview
20 hours ago
Physician’s Malpractice Insurance not Available When License Revoked

Applicant for Insurance is Obligated to Advise Insurer in Material Changes After Application Was Signed

Post number 5371

Read the full article at https://www.linkedin.com/pulse/physicians-malpractice-insurance-available-when-zalma-esq-cfe-fmpxc and https://zalma.com/blog.

Doctor Criminally Charged and License Suspended After Application Signed had Policy Rescinded for Failure to Advise Insurer of Change

In Xiang (Sean) Yuan, M.D. v. Positive Physicians Insurance Company, No. 1821 EDA 2025, No. J-A08033-26, Superior Court of Pennsylvania (May 29, 2026) Dr. Xiang (Sean) Yuan, a physician, sought renewal of his professional liability insurance policy with Positive Physicians Insurance Company (PPIC) in June 2020 and again in May 2021.

In the June 2020 renewal application, he answered “no” to questions asking whether he knew of any circumstances that might lead to a professional liability claim.

Two days after signing the 2020 renewal application, Dr. Yuan was charged with 36 criminal offenses, and...

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