Zalma on Insurance
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August 28, 2026
A Factual Dispute is Enough to Require Trial

No Summary Judgment for Bad Faith for Lack of Evidence

Post 5437

Posted on August 28, 2026 by Barry Zalma

Genuine Dispute of Material Fact Avoids Summary Judgment

In Riley and Rebecca Ross v. Allstate Vehicle And Property Insurance Company, and Illinois Corporation, No. 2:25-CV-00006-JAG, United States District Court, E.D. Washington (August 18, 2026), Pending before the USDC was Defendant’s Motion for Partial Summary Judgment the plaintiffs brought claims against Allstate arising from its handling of an insurance claim. They alleged Allstate failed to make proper payment, adequately investigate the loss, retain an expert, respond to communications, and properly value damages including alternative living expenses and damage to a hydronic heating system.

Plaintiffs argued Defendant failed “to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies.”

ISSUES

Allstate sought dismissal of the plaintiffs’ claims under the Insurance Fair Conduct Act (IFCA), Consumer Protection Act (CPA), insurance bad faith, and negligent claims handling. Allstate also sought to bar recovery of attorney’s fees.

LAW

The USDC applied the summary judgment standard: summary judgment is proper only where there is no genuine dispute of material fact and the movant is entitled to judgment as a matter of law.

For the IFCA claim, Washington law permits suit where an insurer unreasonably denies coverage or payment of benefits. The USDC rejected an expanded “constructive denial” theory.

For the CPA claim, the plaintiffs had to show an unfair or deceptive act, trade or commerce, public interest impact, injury, and causation. Violations of certain insurance regulations can constitute per se unfair or deceptive acts.

For bad faith, plaintiffs had to show unreasonable conduct by the insurer. Summary judgment is improper if material facts remain disputed regarding the reasonableness of the insurer’s actions. Fees are available in coverage disputes, not merely disputes over claim valuation or damages.

DISCUSSION / ANALYSIS

Where the insurer pays or offers to pay a paltry amount that is not in line with the losses claimed, is not based on a reasoned evaluation of the facts (as known or, in some cases, as would have been known had the insurer adequately investigated the claim), and would not compensate the insured for the loss at issue, the benefits promised in the policy are effectively denied.

The court dismissed the IFCA claim because Allstate had not denied coverage or benefits. The court concluded that Washington law does not recognize a constructive denial theory under IFCA where the insurer made substantial payment but disputed the amount owed.

The CPA claim survived in part. The court dismissed CPA theories based on failure to adopt investigation standards, failure to affirm or deny coverage, failure to acknowledge communications, and settlement standards because plaintiffs failed to identify sufficient supporting facts. However, CPA theories based on allegedly unreasonable investigation and alleged underpayment sufficient to compel litigation survived because factual disputes remained.

The bad faith and negligent claims handling claims also survived. Plaintiffs presented enough evidence to create a factual dispute over whether Allstate’s investigation and valuation were reasonable, including the lack of an in-person adjuster inspection and handling of the heating-system damage.

The court rejected fees because the dispute concerned claim valuation and damages, not coverage. Allstate acknowledged coverage. The disagreement was over the extent and value of the loss.

CONCLUSION

Allstate’s motion for partial summary judgment was granted in part and denied in part. The IFCA claim was dismissed with prejudice. CPA claims based on WAC 284-30-330(4) and (7) remained. The plaintiffs’ breach of contract, bad faith, declaratory judgment, and negligent claims handling claims remained pending.

The USDC concluded that as to the IFCA claims, no issue of genuine factual dispute exists, consequently summary judgment is appropriate. Plaintiff also presented a genuine issue of fact regarding the Bad Faith and Negligent Claims Handing claim. Lastly, the USDC found fees do not apply.

ZALMA OPINION

Bad faith is a tort that requires a finding of unreasonable conduct by the insurer. The facts to prove that tort was not proved but the plaintiff presented sufficient evidence to raise a genuine issue of fact regarding the Bad Faith and Negligent Claims Handing claim. Whether they proved the torts at trial will be established by a jury.

(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
November 09, 2026
Excess Insurers May Face Declaratory Relief and Bad Faith Claims Before Coverage Attaches

Is Exhaustion Required to Seek Declaratory Relief From an Excess Insurer?

Post 4578

Posted on November 9, 2026 by Barry Zalma

In Fox Paine & Company, LLC, et al. v. Twin City Fire Insurance Company et al., S287404, 593 P.3d 832, 593 P.3d 838, 346 Cal.Rptr.3d 541, Supreme Court of California, (July 27, 2026) the Supreme Court noted that Insurance is sometimes procured in a series of layers, with an insured acquiring a primary insurance policy that provides an initial layer of coverage for loss or liability and an excess insurance policy or policies that provide additional coverage in the event the underlying coverage is exhausted. Usually, the first layer of coverage must be exhausted before the excess layers are available to the insured.
Exhaustion

Fox and Paine’s investment-firm dispute generated extensive litigation and competing insurance claims. Their insurance tower consisted of a $10 million primary policy and four $10 million excess layers.

The Fox Parties alleged that insurers paid their rivals, withheld information,...

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November 05, 2026
Convicted of Felony Fraud You Lose the Right to Vote

Payment of Fines & Completion of Probation Reinstates Right to Vote

Post 4576

Posted on November 5, 2026 by Barry Zalma

To Restore Voting Rights The Felon Must Pay Fines of $546.00

In Florida Supreme Court Mediator Ethics Advisory Committee, ETH F-26-377, No. F-26-377 (October 29, 2026) citizen unnamed and to Ron Desantis Governor, Cord Byrd the Secretary of State Florida Division of Elections provided an advisory opinion to a convicted felon about his right to vote:

To: [redacted] We received your request for an advisory opinion. You indicate that you have one or more felony convictions and request whether you are eligible to vote, including whether you have any outstanding legal financial obligations under section 98.0751, Florida Statutes, and, if so, a statement of the amount that must be paid to make you eligible to vote, and an explanation of how the amount was calculated.

The Division hereby responds to your request pursuant to its legal authority under section 106.23(2), Florida Statutes, and Florida ...

November 04, 2026
Castro Valdez Had an Available Administrative Appeal and Failed to Establish a Ground for Excusing

Administrative Review Permits the Agency to Apply its Expertise

Post 4574

In Erwin Jordan Castro Valdez v. Warden, Otay Mesa Detention Center, No. 26-cv-06147-BAS-JLB, United States District Court, S.D. California (October 30, 2026) Castro Valdez, a Cuban national paroled into the United States, was arrested on June 23, 2026, for alleged insurance fraud, grand theft, and making a false report to law enforcement. In his first habeas action, the district court ordered a bond hearing within fourteen days to determine whether the changed circumstances justified revoking his parole.

An Immigration Judge subsequently denied bond because of his pending state criminal case. Castro Valdez filed a second petition under 28 U.S.C. § 2241, challenging that determination and requesting immediate release without first appealing to the Board of Immigration Appeals (BIA).

LAW

According to the supplied text, § 2241 does not expressly require administrative exhaustion, but courts impose exhaustion as a prudential requirement. ...

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