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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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August 27, 2026
Offer Made and Accepted Creates Enforceable Contract

Policy Limits Demand Accepted Settles Claim

Post 5434

Posted on August 26, 2026 by Barry Zalma

See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute

In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange,  The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.

FACTUAL BACKGROUND

Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.

Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested declarations page confirming the applicable limits.

Wood later refused to complete the settlement documentation after reviewing Archer’s asset declaration and discovering possible additional assets.

Wood filed suit against Archer, and Farmers separately sued Wood for breach of contract, declaratory relief, and specific performance.

LAW

A settlement agreement is governed by ordinary contract principles.

Contract formation requires mutual consent to lawful terms, generally shown through an offer and an acceptance. Mutual assent is evaluated objectively by the parties’ outward manifestations, not by undisclosed subjective intent.

ANALYSIS

The Court of Appeal concluded that Wood’s July 30, 2021 letter objectively offered to settle her bodily injury claim for the available policy limits if Farmers accepted in writing by the stated deadline and provided the declarations page. Farmers satisfied those conditions by timely tendering the $15,000 per-person limit and supplying policy documentation.

Because the demand letter expressly converted the $100,000 figure into a policy-limits demand if the policy limits were lower, Farmers’ $15,000 acceptance was not a counteroffer but was an acceptance with consideration.

The Court of Appeals rejected Wood’s argument that Archer’s asset declaration altered or defeated the settlement. Wood’s demand did not condition settlement on a satisfactory asset declaration, and Farmers’ later inclusion of such a declaration did not create a novation (a new contract) noR rescind the agreement, nor add a new material term.

The enforceable agreement was formed when Farmers accepted the policy-limits demand on August 25, 2021.

DISCUSSION

The decision emphasizes that policy-limits settlement demands are interpreted according to their objective wording. An insurer may accept by tendering the actual policy limit.

Post-acceptance paperwork generally does not undo an otherwise formed settlement unless the original offer made that paperwork a condition of acceptance or the parties clearly agreed to substitute new obligations.

Enforcement of clear pre-litigation settlement  communications discourages parties from avoiding settlement based on later dissatisfaction with collateral information not made a condition of the offer.

BENEFIT TO INSRERS

For insurers, the case reinforces the importance of timely written acceptance and complete compliance with the demand’s stated conditions.

FOR CLAIMANTS

The decision highlights the need to expressly include any asset-disclosure or additional documentation requirements as conditions of settlement if they are intended to affect contract formation.

CONCLUSION

The Court of Appeal granted Farmers’ writ petition and directed the trial court to vacate its order denying summary judgment or summary adjudication and to enter a new order granting summary adjudication on Farmers’ declaratory relief cause of action.

The court held that Farmers’ August 25, 2021 response created a binding settlement agreement resolving Wood’s bodily injury claim against Archer for the $15,000 policy limit.

ZALMA OPINION

Claimants, hoping to create a bad faith case against an insurer often make immediate policy limits demands before litigation. In this case the Plaintiff made a $100,000 demand or a policy limits demand if the limit is less than $100,000. Farmers accepted and paid and the Plaintiff refused to honor the acceptance of the demand. Basic contract law was applied, the plaintiff made an offer, Farmers accepted the offer and paid consideration. The contract was confirmed and the settlement was enforced.

(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...

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September 17, 2026
Convicted on 29 Tax-Refund-Fraud Counts

150 Months in Prison for Tax Fraud
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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 ...

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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 ...

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14 hours ago
Zalma’s Insurance Fraud Letter – October 15, 2026

ZIFL – Volume 30, Issue 20 Subscribe to ZIFL here https://lnkd.in/gfpn78FM

Posted on October 15, 2026 by Barry Zalma

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 is written by Barry Zalma.

It is provided FREE to anyone who visits the site at https://lnkd.in/gVT5G9s

Six Insane Fraud Schemes the Trump Administration Has Uncovered Stealing from the taxpayer has now become a multi-billion-dollar industry in America. Obamacare has been a magnet for scammers.

Florida Insurance Agent Pleads Guilty in $300,000 Premium Finance Scheme

Daniel Raney, 41, who managed Raney Insurance and Raney Ventures in Pensacola, was arrested after AFCO Direct.

RIFE WITH FRAUD ALLOWS DEMANDS TO ESTABLISH RESTITUTION

Six Insane Fraud Schemes the Trump Administration Has Uncovered

Stealing from the taxpayer has now become a multi-billion-dollar industry in America – and the ...

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October 14, 2026
District Court has Wide Discretion in Sentencing

Sentence for Stealing from Veterans Administration Reasonably Considers State Insurance Fraud & Arson Convictions

Post 4863

Posted on October 14, 2026 by Barry Zalma

In United States Of America v. Anthony Curtis Brewer, No. 26-10745, United States Court of Appeals, Eleventh Circuit (October 8, 2026) Anthony Curtis Brewer became the fiduciary for an incapacitated recipient of Department of Veterans Affairs survivor benefits and agreed to use her funds solely for her care and support without commingling them with his own.

The VA determined that he misused $67,232.33 and removed him as fiduciary in 2022. Brewer pleaded guilty to theft of more than $1,000 in government property under 18 U.S.C. § 641. At sentencing, the district court attributed $53,567 in loss to him, producing an advisory Guidelines range of 15 to 21 months.

Citing the victim’s vulnerability, Brewer’s attempts to avoid responsibility, and his other fraudulent conduct — including state convictions for arson and insurance fraud — the court ...

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October 13, 2026

Title Insurance Only Insures Real Property

Posted on October 13, 2026 by Barry Zalma

When a Seller Advised it Could Not Obtain Title to the Home Fraud Can’t be Proved

A Manufactured Home is Personal Property Until it Becomes Real Property

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In Dale Johnson and Rose Johnson, Husband and Wife v. Stewart Title Guaranty Co., and Lennar Mortgage, LLC; Low Va Rates, LLC; Sandpoint Title Insurance, Inc.; Village Capital & Investment, LLC; and David Cassel, Engineer Agent; and Unknown Does 1-50, inclusively, No. 53126, Court of Appeals of Idaho (October 9, 2026)  Dale and Rose Johnson purchased Idaho real property in 2012 with a manufactured home on it. Their purchase addendum acknowledged that the seller could not obtain title to the home, that evidence of title and an ALTA-7 endorsement might not be available, and that they accepted the home “as is.”

In 2020, after a HELOC application was denied, the Johnsons learned that the home had been wrecked and decertified in 2004 and that its 2006 conversion to real ...

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