Competing Inferences About Intent or Falsity Defeats Summary Judgment
Post number 5360
Dispute Over Material Facts Makes Summary Judgment Impossible
Read the full article at https://www.linkedin.com/pulse/dispute-over-two-claims-must-go-trial-barry-zalma-esq-cfe-ds59c and at https://zalma.com/blog plus more than 5350 posts.
In Darlene Mendoza Gonzales v. Safeco Insurance Company Of America, No. 2:24-cv-01832-RAJ, United States District Court, W.D. Washington, Seattle (May 22, 2026) Plaintiff Darlene Mendoza Gonzales owned a home in Tacoma, Washington insured under a Safeco homeowner’s policy.
FACTUAL BACKGROUND
For the second loss, Gonzales retained Pacific Public Adjusters (PPA), which submitted repair estimates substantially higher than Safeco’s estimate.
LAW – SUMMARY JUDGMENT STANDARD
Summary judgment is appropriate only where there is no genuine dispute of material fact and the moving party is entitled to judgment as a matter of law under Rule 56. Courts do not weigh evidence or resolve credibility disputes at this stage.
INSURANCE FAIR CONDUCT ACT (IFCA)
Under Washington law, an insured may maintain an IFCA claim by showing that the insurer unreasonably denied coverage or unreasonably denied payment of benefits.
BREACH OF CONTRACT
An insurer may breach its contractual obligations by failing to conduct a reasonable investigation, by making a compromise offer based on speculation or inaccurate information.
BAD FAITH / NEGLIGENT CLAIMS HANDLING / CPA
An insurer acts in bad faith when its conduct is unreasonable, frivolous, or unfounded.
FRAUD COUNTERCLAIM
Fraud requires proof of intentional misrepresentation or concealment.
DISCUSSION / ANALYSIS - Safeco’s Motion
The court denied Safeco’s request for summary judgment on Gonzales’s IFCA claim because the record contained conflicting evidence about whether Safeco’s April 2024 payment was a reasoned valuation or an unreasonably low offer.
The disputed facts prevented the court from concluding as a matter of law that Safeco acted reasonably.
Gonzales’s Motion
The court denied Gonzales’s request for summary judgment on Safeco’s fraud counterclaim.
Because neither side prevailed on summary judgment, the court declined to reach Safeco’s arguments concerning Gonzales’s entitlement to attorneys’ fees under IFCA and the CPA.
CONCLUSION
The court denied both parties’ motions for summary judgment in full. It held that the record contained multiple genuine disputes.
ZALMA OPINION
Summary judgment is a wonderful tool to resolve lawsuits short of trial. However, it only works when all of the facts resolve all disputes.
(c) 2026 Barry Zalma & ClaimSchool, Inc.
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The Largest Residential Burglary of All Time
Post 5407
Fraud & the Fear of Bad Faith Suits
Posted on July 22, 2026 by Barry Zalma
See the full video at https://lnkd.in/gWQQEySW and at https://lnkd.in/gyhdK6wv
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime.
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime.
After ...
Chutzpah is not Enough
Post 5397
Posted on July 20, 2026 by Barry Zalma
See the video and at https://lnkd.in/gNUs2XzT and at https://lnkd.in/g2MawyzX
Magistrate Issues a Search Warrant if there is a Fair Probability that Contraband or Evidence of a Crime will be Found in a Particular Place.
In United States Of America v. Frank Suess, et al., CRIMINAL No. 3:24-308, United States District Court, M.D. Pennsylvania (July 16, 2026) a federal grand jury indicted Frank Suess, Melissa Driscoll, and others in a 55-count health care fraud and anti-kickback prosecution arising from an alleged scheme involving medically unnecessary prescription “foot baths.”
As part of the investigation, the FBI obtained an August 19, 2022 warrant to search Driscoll’s Sterling Pharmacy Yahoo email account for emails from January 1, 2018 through December 31, 2020. Driscoll moved to suppress the resulting evidence, arguing that the warrant lacked probable cause, was overbroad, and rested on material misstatements and omissions.
LAW:
The ...
Fraud Shouldn’t Pay
Post 5396
See the video and at https://rumble.com/v7ctgmq-the-great-jewel-theft.html at https://youtu.be/aRbQ2sJfGwA
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the ¬¬¬Perpetrators than any Other Crime.
The Insured purchased, for the first time in his life, a policy of Personal Articles Floater Insurance (PAF) scheduling $125,000 worth of ladies jewelry. He advised the insurer that the jewelry was always kept in a class E safe at his residence. He also told the insurer that he was employed full time as the owner of a gasoline service station and that he had never been canceled or suffered a previous loss.
One month after the policy was ...
Specific Jurisdiction is Related to an Activity Conducted Within the Forum State.
Post 5408
Posted on July 23, 2026 by Barry Zalma
In New Jersey Manufacturers Insurance Company v. Changan Chu, No. 14-25-00965-CV, Court of Appeals of Texas, Fourteenth District (July 21, 2026) NJM issued an automobile insurance policy in New Jersey to Changan Chu while Chu was a New Jersey resident.
Chu was injured in an auto-pedestrian collision in Harris County, Texas, allegedly caused by an uninsured driver. Chu sued the driver and NJM, seeking a declaration that his UM/UIM coverage was in force and provided $300,000 in limits. NJM filed a special appearance supported by affidavit evidence showing it was a New Jersey corporation with its principal place of business in New Jersey, had no offices, agents, employees, advertising, registration, or insurance business in Texas, and did not insure any person, property, or risk located in Texas. Chu did not file evidence opposing the special appearance.
LAW
A Texas court may exercise ...
Victims of Fraud Should Always Fight Back Proactively
Post 5398
Posted on July 21, 2026 by Barry Zalma
Cross-Claim Against Fraudsters Successful
In Dual Diagnosis Treatment Center, Inc., et al. v. Health Net, Inc., et al., Health Net Life Insurance Company, B331260, California Court of Appeals, Second District, Third Division (July 16, 2026) a trial verdict in favor of Health Net and against Sovereign, a network of mental health and substance use disorder treatment centers, and Health Net, Inc., Health Net of California, Inc., Health Net Life Insurance Company, and Managed Health Network, Inc. (collectively, Health Net) was appealed to the California Court of Appeals.
FACTUAL BACKGROUND
Between 2014 and 2016, Sovereign submitted claims to Health Net for medical care provided to more than 400 patients. Health Net paid some claims but rejected many others. Sovereign, as the patients' assignee, sued Health Net for breach of contract, insurance bad faith, and breach of the Employee Retirement Income Security Act of 1974 (ERISA)....
The Only Solution to Fraud is to Take the Profit Out of the Crime
It Takes Courage to Fight the Fraudster
Post number 5395
Posted on July 16, 2026 by Barry Zalma
In Vivian Maritza Triana Marin, Sebastian Arroyave Penagos, and Daniel Arroyave Penagos v. Marc J. Paynter and Transport Marc Paynter Inc., No. 23-CV-6498, United States District Court, E.D. New York (July 10, 2026) Plaintiffs sued Defendants in diversity after a rear-end collision on the Whitestone Expressway in Queens, New York. Plaintiffs were in a Subaru driven by Vivian Maritza Triana Marin, while Defendant Marc J. Paynter drove a Transport Marc Paynter Inc. tractor-trailer.
Facts:
Dashcam footage from Defendants’ vehicle showed Plaintiffs’ vehicle braking suddenly in the left lane despite an open roadway ahead. Marin could not identify a specific reason for braking, the passenger plaintiffs did not know why she braked, and a non-party witness testified that Plaintiffs’ vehicle stopped abruptly for no apparent reason.
The Accident occurred when ...
