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May 06, 2026
Proper Inconsistent Pleading Defeats Policy Anti-Assignment Condition

Amended Complaint Provides Escape from Anti-Assignment Condition
Post number 5345

Read the full article at https://www.linkedin.com/pulse/proper-inconsistent-pleading-defeats-policy-condition-barry-mrugc, shttps://www.linkedin.com/pulse/proper-inconsistent-pleading-defeats-policy-condition-barry-mrugc and at https://zalma.com/blog plus more than 5300 posts.

State Farm’s Responsive Pleading Defeated Motion on Anti Assignment Condition

In Tyra Caire Treadway v. State Farm Fire And Casualty Company, Civil Action No. 23-6834, United States District Court, E.D. Louisiana (April 28, 2026) Plaintiff Tyra Caire Treadway owned property at 7000-02 Jeannette Street, New Orleans, Louisiana, which was insured under a State Farm homeowners’ policy.

Hurricane Ida struck Louisiana on August 29, 2021, causing damage to the property. Nearly two years later, on August 9, 2023, Treadway sold the property to M1SRJT Jeanette, LLC and assigned her State Farm insurance claim, including the right to pursue additional damages and penalties for alleged bad faith conduct by State Farm.

Subsequently, Treadway filed an Amended Complaint adding M1SRJT as co-plaintiff, asserting M1SRJT’s status as assignee of the insurance claim.

THE POLICY

The State Farm Policy’s Assignment of Claim condition Provided:

“Assignment to another party of any of your rights or duties under this policy regarding any claim, or any part of any claim, whether the assignment is made prior to or after the loss, will be void. We will not recognize any assignment, unless we give our written consent. However, once you have complied with all policy provisions, you may assign to another party, in writing, payment of claim proceeds otherwise payable to you.“

LAW

State Farm’s policy contains an anti-assignment clause, stating that the assignment of claims or rights under the policy is void unless State Farm provides written consent, except for the payment of claim proceeds after compliance with all policy provisions.

State Farm, in its Answer, denied M1SRJT’s status as assignee and raised defenses including lack of standing for Treadway (as she had assigned her rights before filing suit) and prescription (statute of limitations) barring Plaintiffs’ claims.

DISCUSSION AND ANALYSIS

State Farm moved for judgment on the pleadings under Rule 12(c), arguing that Plaintiffs lacked standing and that the assignment was void due to the policy’s anti-assignment clause. Plaintiffs opposed the motion, contending that the assignment was valid and that M1SRJT, as assignee, could pursue the claim for damages.

CONCLUSION

The Court denied State Farm’s motion for judgment on the pleadings, allowing Plaintiffs’ claims to proceed. The denial indicates that the Court found sufficient grounds for Plaintiffs to pursue their claims, either as assignor (Treadway) or assignee (M1SRJT), despite State Farm’s defenses based on the anti-assignment clause and standing.

A motion brought pursuant to Rule 12(c) is designed to dispose of cases where the material facts are not in dispute and a judgment on the merits can be rendered by looking to the substance of the pleadings and any judicially noticed facts.

The “material fact” at issue here is whether Treadway assigned the insurance claim to M1SRJT before filing the lawsuit. Contrary to State Farm’s assertion, that fact is very much “in dispute.” For one, State Farm denied the allegation in its Answer. What’s more, State Farm’s Answer excerpted from the insurance policy at issue, which expressly states that State Farm will “not recognize any assignment, unless we give our written consent.”

The pleadings here-which include State Farm’s Answer-squarely present the issue of assignment as a disputed question.

Any inconsistencies found in the factual and legal theories presented in the parties’ pleadings are permissible under Fed.R.Civ.P. 8(d), which allows a party to “state as many separate claims or defenses as it has, regardless of consistency.” Indeed, under that rule, a party “may set out 2 or more statements of a claim or defense alternatively or hypothetically, either in a single count or defense or in separate ones.

Fortunately for both parties, the Federal Rules of Civil Procedure permit the pleading of such apparent inconsistencies any inconsistency failing to admit the Agreement is a valid enforceable contract while also asserting claims based on breach of the Agreement is not a valid reason for dismissal. Accordingly, the Court denies Defendant’s motion for judgment on the pleadings.

ZALMA OPINION

Inconsistent pleadings worked against a series of answers to the inconsistent pleading with State Farm denying the assignment and then seeking to dismiss because of its anti-assignment clause. Of course, State Farm can change its pleading and admit the truth of the alleged assignment and them move for summary judgment.

(c) 2026 Barry Zalma & ClaimSchool, Inc.

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00:07:48
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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
22 hours ago
Restitution Sentence Affirmed

Psychiatrist Who Was Convicted of Fraud Asked the First Circuit to Reduce his Punishment
Post 4851

Posted on September 24, 2026 by Barry Zalma

Fraud to Private and Public Health Insurers Doesn’t Pay

In United States v. Gustavo Kinrys, Nos. 24-1592, 24-1716, United States Court of Appeals, First Circuit (September 21, 2026) Gustavo Kinrys, a Massachusetts psychiatrist, submitted fraudulent claims to private and public health insurers from 2015 through 2018, including bills for more than 1,000 sessions when he or the purported patient was outside the country. When insurers requested supporting records, he delayed through a fictitious office manager and created false documentation.

A jury convicted Kinrys on fourteen counts. The district court imposed a 99-month sentence, calculated intended loss at slightly more than $19 million based on billed amounts, ordered $6,537,309.59 in restitution, and ordered $6,527,391.19 in forfeiture.

At sentencing, the district court calculated Kinrys’s base offense level to be ...

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September 23, 2026
Payment and Performance Bonds Are Not Designed to Profit from Failure to Perform

The Collateral-Source Rule is a Narrow Exception to the Prohibition Against Double Recovery

Post 4850

Posted on September 23, 2026 by Barry Zalma

A Surety Stands In The Principal’s Shoes And May Assert The Principal’s Defenses.

In Hudson Insurance Company v. Archer Western Federal, JV, No. 1:24-cv-544 (PTG/IDD), United States District Court, E.D. Virginia, Alexandria Division (September 18, 2026) Archer Western Federal, JV (“AWF”), the prime contractor for a new fire station at Marine Corps Base Quantico, subcontracted roofing work to Eastern General Contractor, Inc. (“EGC”) for $456,330.

Hudson Insurance Company (“Hudson”) issued payment and performance bonds, each with a $456,330 penal sum.

AWF later sought recovery under both bonds.

LAW

Under Virginia law, the collateral-source rule is a narrow exception to the prohibition against double recovery. A surety stands in the principal’s shoes and may assert the principal’s defenses. Liability under the bonds required EGC’s ...

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September 22, 2026
Fraudsters May Not Enjoin Suit Alleging Fraudulent PIP Claims

Defendants May Not Enjoin a Suit Alleging They Defrauded the Plaintiffs

Plaintiffs, automobile insurers, sued medical professionals and healthcare entities, alleging a scheme to submit fraudulent personal injury protection (PIP) bills and supporting documentation for services that were not performed or were medically unnecessary. The complaint asserted common-law fraud, violations of the New Jersey Insurance Fraud Prevention Act (IFPA), aiding and abetting fraud, unjust enrichment, and declaratory relief.

While the action was pending, Plaintiffs moved to stay and enjoin related PIP arbitrations. A magistrate judge recommended denial. in State Farm Guaranty Insurance Company v. Tri-County Chiropractic And Rehabilitation Center P.C., Civil Action No. 22-4852, United States District Court, D. New Jersey (September 15, 2026)

After the New Jersey Supreme Court decided Allstate New Jersey Insurance Company v. Carteret Comprehensive Medical Care, P.C., the federal court reopened the case and considered the parties’ supplemental...

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