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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June 18, 2026
Payment of All Policy Benefits Does not Defeat Bad Faith in California

Bad Faith With No Breach of Contract

Post number 5375

Essential Condition of a Tort of Bad Faith Ignored in California

Read the full article at https://www.linkedin.com/pulse/payment-all-policy-benefits-does-defeat-bad-faith-zalma-esq-cfe-yhnec and at https://zalma.com/blog.

In Jennifer Bornoff v. State Farm General Insurance Company, B339796, California Court of Appeals, Second District, First Division (May 1, 2026) Bornoff’s business suffered two burglaries in March 2022. She submitted claims promptly, and State Farm never disputed coverage, only valuation.

After months of delay and poor communication, State Farm paid the property-loss benefits about four months later, shortly after Bornoff sued.

ISSUE:

Whether State Farm was entitled to summary adjudication of Bornoff’s bad-faith claim when it had paid all policy benefits but allegedly caused extracontractual economic loss through unreasonable delay.

RULE:

In California, an insurer may be liable for bad faith if it unreasonably delays payment of benefits. Payment of all policy benefits does not defeat bad faith if the insured suffered separate economic harm, such as attorney’s fees or lost business income.

HOLDING:

State Farm was not entitled to summary adjudication on the bad-faith claim.

REASONING:

State Farm only showed that it eventually paid the policy benefits, but it did not negate Bornoff’s alleged extracontractual losses, including attorney’s fees and lost vendor income. The evidence also raised a triable issue as to whether the four-month delay was unreasonable, especially because State Farm never disputed coverage and failed to respond to repeated communications.

DISPOSITION:

The judgment was reversed and remanded and the Court of Appeals concluded that summary adjudication was proper only on the breach of contract claim, not the bad-faith claim.

State Farm’s undisputed evidence that it paid Bornoff all benefits due under the parties’ contract did not satisfy its initial burden of production to show that no triable issue existed as to actionable economic loss.

ZALMA OPINION

This case is interesting, and odd, because it found there was no breach of contract, the sine qua non basic minimum for a bad faith case and still found a right to proceed with the bad faith suit because the insured claimed an economic loss due to delay. Without the indispensable, essential, condition, of breach of contract for a bad faith case did not exist yet the California Court of Appeals found a right to bad faith anyway.

(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
15 hours ago
Jury Found Prudential to be the Victim of Fraud

Insured’s Ordered to Pay Insurer for Fraud by the Insureds

Post 4573

Posted on November 3, 2026 by Barry Zalma

In The Prudential Insurance Company Of America v. Carol Gardina and George Gardina, No. 6:23-cv-1125-JSS-DCI, United States District Court, M.D. Florida, Orlando Division (October 22, 2026).

THE JURY TRIAL AND VERDICT

Plaintiff sued Defendants for numerous causes of action stemming from its allegations that Defendants fraudulently collected benefits under their long-term care insurance policies. Plaintiff's case proceeded to a nine-day jury trial, after which the jury found Defendants liable for fraudulent misrepresentation, fraudulent concealment, and civil conspiracy.

The jury also found Defendant Carol Gardina liable to Plaintiff for $1,930,129 in compensatory damages and Defendant George Gardina liable to Plaintiff for $12,496 in compensatory damages and $20 in punitive damages. Thereafter, the court entered judgment in Plaintiff's favor and awarded Plaintiff $1,930,129 in compensatory damages from...

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November 02, 2026
Zalma’s Insurance Fraud Letter – November 1, 2026

ZIFL – Volume 30, Issue 21

Posted on November 2, 2026 by Barry Zalma

Subscribe to ZIFL Here https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

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/

DOJ, ATF, Law Enforcement Partners Conclude Operation Show Me Justice

435 Dangerous Offenders Arrested, 166 Illegal Firearms Seized, 81 Kg Illicit Drugs off the streets in St. Louis

The Department of Justice, BATF, U.S. Marshals Service (USMS), US Attorney Missouri announced the ...

November 02, 2026
Zalma’s Insurance Fraud Letter – November 1, 2026

ZIFL – Volume 30, Issue 21

Posted on November 2, 2026 by Barry Zalma

Subscribe to ZIFL Here https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

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/

DOJ, ATF, Law Enforcement Partners Conclude Operation Show Me Justice

435 Dangerous Offenders Arrested, 166 Illegal Firearms Seized, 81 Kg Illicit Drugs off the streets in St. Louis

The Department of Justice, BATF, U.S. Marshals Service (USMS), US Attorney Missouri announced the ...

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