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May 14, 2026
When Facts Disputed Summary Judgment Fails

Frozen Pipes Not Covered if Thermostat not Set Over 50 Degrees

Post number 5351

Read the full article at https://www.linkedin.com/pulse/when-facts-disputed-summary-judgment-fails-barry-zalma-esq-cfe-vffse and https://zalma.com/blog plus more than 5300 posts.

Proof without Contradiction Needed for Summary Judgment

In Kenneth Taylor v. State Farm Fire & Casualty Co., Civil Action No. 24-0882, United States District Court, W.D. Louisiana, Shreveport Division (May 7, 2026) the District Court issued a Memorandum Ruling denying State Farm’s motion for summary judgment (May 7, 2026).

FACTS

State Farm issued a homeowner’s policy to Kenneth Taylor covering a multi-story townhouse in Shreveport, Louisiana. Taylor lived in California during renovations and relied on local contacts to check the property; the parties dispute who had access and how often the home was inspected.

Taylor testified he set the thermostat to roughly 60–65°F before leaving the townhouse about two months before the freeze. Taylor’s handyman, Raymond George, testified he visited “once or twice a week,” ensured the heater worked, and set the thermostat around 60–70°F during winter visits.

After a January 2024 freeze, a pipe burst in the attic and water leaked throughout the townhouse; a neighbor reported water intrusion.

Taylor promptly filed a claim; State Farm inspected within days and denied coverage, asserting Taylor had the thermostat set to “zero” and/or “off,” and that inspection showed a 41°F reading with the system off.

LAW

Summary judgment (Fed. R. Civ. P. 56(a)):

Granted only if there is no genuine dispute of material fact and the movant is entitled to judgment as a matter of law; the court views evidence in the light most favorable to the nonmovant and does not weigh credibility at this stage.
Contract interpretation (Louisiana law):

Insurance policies are contracts construed under Louisiana Civil Code principles; clear and unambiguous terms are enforced as written.
Coverage condition for frozen pipes:

Policy excluded frozen-pipe losses unless the insured used “reasonable care to maintain heat” in the building at 55°F or higher.

Bad faith (La. R.S. § 22:1892):

Louisiana imposes a duty of good faith and fair dealing on insurers. La. Stat. Ann. § 22:1892 (“An Insurer.owes its insured a duty of good faith and fair dealing.”). To establish a bad faith claim, the insured “must show that (1) an insurer has received satisfactory proof of loss, (2) the insurer failed to tender payment within thirty days of receipt thereof, and (3) the insurer’s failure to pay is arbitrary, capricious or without probable cause.”

A genuine dispute over coverage generally defeats bad-faith penalties.

DISCUSSION / ANALYSIS

Breach of Contract (Coverage for Frozen Pipe)

The central coverage question was whether Taylor exercised “reasonable care” to keep the townhouse heated at or above 55°F. State Farm argued the condition failed because Taylor had not personally visited for two months, could not specify inspection frequency, and the post-loss condition suggested low temperature and an “off” thermostat.

A genuine dispute exists whether Taylor exercised reasonable care to maintain the townhouse’s heat above 55 degrees. First, Taylor testified that he set the thermostat to a temperature between 60 and 65 degrees before he left the townhouse two months earlier.

BAD FAITH (La. R.S. § 22:1892)

State Farm contended it had a reasonable basis for nonpayment because its investigation allegedly revealed conflicting accounts about property access and because it believed Taylor had the thermostat turned off or set to “zero” before the freeze.

The court found a triable issue on whether State Farm’s denial was supported by probable cause. Evidence, viewed favorably to Taylor, indicated State Farm’s initial denial may have stemmed from a miscommunication. Taylor attempted to correct the record early, provided utility bills showing pre-loss electricity usage, and George reported regular checks and thermostat settings above 55°F.

CONCLUSION

The court denied State Farm’s motion for summary judgment on both the breach-of-contract and bad-faith claims because the record contains genuine disputes of material fact about (1) whether Taylor used reasonable care to maintain heat at or above 55°F and (2) whether State Farm had probable cause for denying payment.

ZALMA OPINION

In my years as a practicing lawyer, before I retired, I filed and won many motions of summary judgment and lost a few. If the facts establish the defense or the allegations without evidentiary dispute the Motion for Summary Judgment would be granted. In this case the evidence showed an dispute that could only be resolved by a trier of fact hearing evidence at trial. State Farm didn’t have the evidence and its motion was properly denied.

(c) 2026 Barry Zalma & ClaimSchool, Inc.

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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
September 25, 2026
Unwise for a Appellant to Represent Himself.

Inadequately Briefed Issues Defeats Appeal

Post 4852

Issues on Appeal Must be Adequately Briefed

Posted on September 25, 2026 by Barry Zalma

In Emy Ojekwe v. Connecticut Transit District Consortium, No. AC 47389, Court of Appeals of Connecticut (September 22, 2026) Emy Ojekwe alleged that he was injured on September 24, 2020, while leaving a bus operated by Connecticut Transit District Consortium, doing business as Greater Bridgeport Transit Authority.

According to his complaint, the wheelchair ramp began to rise before he had fully exited, causing his wheelchair to fall backward and allegedly injuring several parts of his body and damaging the wheelchair. The defendant denied negligence and alleged comparative negligence. After a two-day jury trial in November 2023, the jury returned a defense verdict.

The trial court denied Ojekwe’s motion to set aside the verdict and for a new trial, and he appealed.

LAW

A trial court’s refusal to set aside a verdict because of counsel’s improper remarks is reviewed for abuse of ...

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September 25, 2026
Unwise for a Appellant to Represent Himself.

Inadequately Briefed Issues Defeats Appeal

Post 4852

Issues on Appeal Must be Adequately Briefed

Posted on September 25, 2026 by Barry Zalma

In Emy Ojekwe v. Connecticut Transit District Consortium, No. AC 47389, Court of Appeals of Connecticut (September 22, 2026) Emy Ojekwe alleged that he was injured on September 24, 2020, while leaving a bus operated by Connecticut Transit District Consortium, doing business as Greater Bridgeport Transit Authority.

According to his complaint, the wheelchair ramp began to rise before he had fully exited, causing his wheelchair to fall backward and allegedly injuring several parts of his body and damaging the wheelchair.

LAW

Refusal to set aside a verdict because of counsel’s improper remarks is reviewed for abuse of discretion.

Appellate claims receiving only cursory treatment, without record citations, supporting authority, or legal analysis, are inadequately briefed.

DISCUSSION

Improper opening remarks.

Defense counsel referred to Ojekwe’s national origin,...

September 24, 2026
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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