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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 22, 2026
Bad Faith Requires the Conscious Doing of a Wrong Because of Dishonest Purpose or Moral Obliquity

Arson and Misrepresentation Sufficient Ground to Deny Claim

Post number 5377

Bad Faith Requires A Showing Of More Than Bad Judgment Or Negligence

Read the full article at https://www.linkedin.com/pulse/bad-faith-requires-conscious-doing-wrong-because-zalma-esq-cfe-xxkdc and at https://zalma.com/blog.

Posted on June 22, 2026 by Barry Zalma

Bad Faith Requires the Conscious Doing of a Wrong Because of Dishonest Purpose or Moral Obliquity
Posted on June 22, 2026 by Barry Zalma

Arson and Misrepresentation Sufficient Ground to Deny Claim
Post number 5377
Bad Faith Requires A Showing Of More Than Bad Judgment Or Negligence

In Jonika K. Nelson v. Allstate Vehicle & Property Insurance Co., et al, No. 4:26-CV-17-RPC-DAS, United States District Court, N.D. Mississippi, Greenville Division (June 15, 2026) under Mississippi law, bad faith requires facts showing that the insurer lacked an arguable or legitimate basis for denying the claim or acted willfully, maliciously, or with gross and reckless disregard for the insured’s rights.

FACTS:

A fire destroyed Jonika K. Nelson’s Greenville, Mississippi home and its contents on November 17, 2024. Nelson had a homeowner’s policy with Allstate and submitted a claim, which Allstate denied based on alleged arson, intentional destruction, and/or misrepresentations.

Nelson contended that she fully cooperated with Allstate’s subsequent investigation and provided all requested information and documentation. Nevertheless, Allstate denied the claim, based on allegations of arson and/or intentional destruction of the property, as well as alleged misrepresentations. After coverage was denied, Trustmark Bank (“Trustmark”), which holds a valid lien on the property as the mortgagee, filed suit in the Circuit Court of Washington County against Nelson to quiet title and to judicially foreclose on the property.

Allstate filed a Motion to Dismiss Certain Counts in Nelson’s Amended Complaint, seeking dismissal of all of Nelson’s extracontractual claims. Specifically, Allstate seeks dismissal of Nelson’s claims for bad faith, negligence, and gross negligence as well as her request for emotional distress and punitive damages. Allstate contends the claims should be dismissed for failure to state a claim pursuant to Rule 12(b)(6).

Nelson sued Allstate, asserting breach of contract, bad faith refusal to pay, negligence, gross negligence, emotional distress damages, and punitive damages. Allstate moved to dismiss all claims except breach of contract.

LAW:

Under Rule 12(b)(6), a complaint must plead enough factual matter to state a plausible claim. Conclusory allegations and legal conclusions are insufficient.

Under Mississippi law, bad faith requires facts showing that the insurer lacked an arguable or legitimate basis for denying the claim or acted willfully, maliciously, or with gross and reckless disregard for the insured’s rights. Negligence requires a duty independent of the contract, while gross negligence requires facts showing reckless indifference or willful, wanton conduct. Emotional distress damages may be available in a breach of contract action if mental anguish was foreseeable and actually suffered. Punitive damages require a viable bad faith showing.

Bad faith requires a showing of more than bad judgment or negligence; indeed, bad faith implies the conscious doing of a wrong because of dishonest purpose or moral obliquity.

DISCUSSION AND ANALYSIS:

The Court found Nelson’s bad faith allegations too conclusory because she did not plead facts explaining why Allstate’s arson, intentional-destruction, or misrepresentation grounds were incorrect or why Allstate’s investigation was unreasonable.

The negligence claim failed because the alleged duty to investigate and evaluate the claim arose from the insurance contract and was not independent of it. The gross negligence claim also failed because Nelson did not plead facts showing willful, wanton, or reckless conduct. The Court allowed the emotional distress damages request to proceed because the breach of contract claim remained unresolved, making dismissal premature.

Because the bad faith claim was inadequately pleaded, the punitive damages request also failed.

CONCLUSION:

Allstate’s motion to dismiss was granted in part and denied in part. The bad faith, gross negligence, and punitive damages claims were dismissed without prejudice; the negligence claim was dismissed with prejudice; and the emotional distress damages request survived. Because Allstate did not challenge the breach of contract claim at this stage and because Nelson has failed to plead sufficient facts, Nelson’s bad faith claim is dismissed without prejudice. Nelson’s breach of contract claim remains pending because Allstate did not seek dismissal of it.

ZALMA OPINION

It doesn’t take a genius lawyer to plead sufficient facts to allege bad faith if there are any facts to support the claim. Ms. Nelson apparently hired an honest and honorable lawyer who alleged the facts he thought he could prove but did not allege facts he or she couldn’t prove. Allstate recognized the facts, moved to dismiss, and left Ms. Nelson with a breach of contract claim she would have a difficult time proving the breach since Allstate probably had evidence sufficient to prove the arson and/or the misrepresentations.

(c) 2026 Barry Zalma & ClaimSchool, Inc.

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The negligence claim failed because the alleged duty to investigate and evaluate the claim arose from the insurance contract and was not independent of it.

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July 08, 2026
Qui Tam Suit Without Materiality Fails

To Prove Fraud Material False Statements Must be Proved

Post number 5389

Posted on July 8, 2026 by Barry Zalma

See the video at and at

Materiality Must Be Judged Objectively.

In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended a tour van driver and related defendants in an underlying auto-collision action brought by Silver Bird Auto Leasing, LLC after a low-speed collision involving Silver Bird’s McLaren and a tour van.

Silver Bird alleged the McLaren was making a legal turn and sought damages including repair costs, loss of use, and diminution in value. The defendants’ insurer later became insolvent, and CIGA took over the defense and ultimately paid $25,000 to settle the underlying action.

After settlement, Heath & Yuen filed a ...

00:06:17
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July 08, 2026
Qui Tam Suit Without Materiality Fails

To Prove Fraud Material False Statements Must be Proved

Post number 5389

Posted on July 8, 2026 by Barry Zalma

See the video at and at

Materiality Must Be Judged Objectively.

In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended a tour van driver and related defendants in an underlying auto-collision action brought by Silver Bird Auto Leasing, LLC after a low-speed collision involving Silver Bird’s McLaren and a tour van.

Silver Bird alleged the McLaren was making a legal turn and sought damages including repair costs, loss of use, and diminution in value. The defendants’ insurer later became insolvent, and CIGA took over the defense and ultimately paid $25,000 to settle the underlying action.

After settlement, Heath & Yuen filed a ...

00:06:17
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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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2 hours ago
Suit Needs Article III Standing

Data Breach Requires Plaintiff’s Own Information was Missued

Post number 5394

The Dismissal Based on Lips’s Failure to Plead Injury in Fact,

Posted on July 14, 2026 by Barry Zalma

Read the full article at https://lnkd.in/gDQZc5vP and at https://zalma.com/blog plus more than 5350 posts.

In Danielle Lips, on behaf of hersef and all others similarly situated v. ACCU Reference Medical Lab, LLC, Civil Action No. 25-13642 (SDW) (CF), United States District Court, D. New Jersey (June 24, 2026) a data-breach class action, the District of New Jersey granted Accu Reference Medical Lab, LLC’s motion to dismiss because Plaintiff Danielle Lips failed to plead Article III standing.

FACTS:

Lips alleged that ACCU, a medical testing laboratory, obtained her personally identifiable information and protected health information through diagnostic testing ordered by her former physician. She claimed the Qilin ransomware group stole ACCU’s data and posted screenshots containing some patients’ unredacted information on the...

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July 13, 2026
Fraudster Injured in Jail Loses Claim

Prisoner’s Failure to Exhaust Administrative Remedies Fatal to Suit

Post number 5393

It Does not Pay to Violate the Conditions of Post-Release Supervision

Posted on July 13, 2026 by Barry Zalma

In Monnie Villarreal v. VitalCore; Nancy Unknown, Nurse Practitioner, VitalCore/Jackson County; John Ledbetter, Sheriff; Geneva Drummond, No. 25-60415, United States Court of Appeals, Fifth Circuit (July 9, 2026) Monnie Villarreal, convicted of conspiracy to commit insurance fraud and later placed on post-release supervision, was arrested for violating the terms of that supervision and detained at the Jackson County Adult Detention Center.

While incarcerated he alleged inadequate diabetes care and later an assault by another inmate, asserting claims under 42 U.S.C. § 1983 against medical providers and correctional officials.

LAW:

The Prison Litigation Reform Act bars a prisoner from bringing a § 1983 action concerning prison conditions until all available administrative remedies are exhausted. ...

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July 10, 2026
Plaintiff 3 Years Late Failed to Set Aside Judgment

Plaintiff Representing Herself Failed to Allege Jurisdiction

Adverse Rulings Alone Almost Never Establish Bias

Post number 5392

Posted on July 10, 2026 by Barry Zalma

In Decheri Hafer v. Farmers Insurance Agency, No. 1:22-cv-0808 KES SKO, United States District Court, E.D. California (June 30, 2026) DeCheri Hafer, proceeding pro se, sued Farmers Insurance Agency alleging perjury, fraud, insurance fraud, and breach of contract.

After screening, the magistrate judge found the complaint deficient and allowed amendment. Plaintiff filed a first amended complaint objecting to all magistrate judges, while defendant moved to dismiss.

The magistrate judge recommended dismissal for lack of subject-matter jurisdiction because the amount in controversy was wholly unsubstantiated. Plaintiff did not object and instead sought default. The district court adopted the recommendation, dismissed the action without prejudice, denied default, entered judgment, and closed the case.

More than three years later, Plaintiff moved under Rule 60(b)(4) ...

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