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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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September 08, 2026
A Loss Certain to Occur is Not Fortuitous or Insurable

Insurance Requires Fortuity to be an Insured Risk
Post 5485

Posted on September 8, 2026 by Barry Zalma

In Industrial Park Center, LLC, doing business as Mainspring Capital Group v. Great Northern Insurance Company, a foreign insurer, No. CV-25-0330-CQ, Supreme Court of Arizona (September 1, 2026).

The United States Court of Appeals for the Ninth Circuit certified the following question to this Court:

"Is damage to property a “fortuitous” loss when, based on the insured’s knowledge at the time the insurance policy issued, it was reasonably foreseeable that such damage was almost certain to occur if certain preventative measures were not taken?"

FACTUAL BACKGROUND

Mainspring owned commercial property leased to Star Fisheries for decades. Star Fisheries’ use of water and salt allegedly caused structural damage over time. In 2010, Mainspring learned of damage and made some repairs but did not implement all recommended preventive measures. In 2021–2022, additional similar structural damage was discovered, and Mainspring submitted a claim under its all-risk policy with Great Northern Insurance Company (GNIC). GNIC denied coverage, arguing the loss resulted from long-term deterioration and excluded causes. The federal district court granted summary judgment to GNIC, finding the loss reasonably foreseeable and almost certain to occur.

GNIC reviewed the loss and retained an engineering firm, Nelson Forensics LLC (“Nelson”), to investigate the damage and its cause. Nelson claimed the deterioration was largely around the space Star Fisheries leased, and the damage was consistent with exposure to a corrosive environment for years or even decades. Nelson also concluded that while Star Fisheries’ water and salt usage “may have exacerbated” damage to a different portion of the building, some of the other damage could not be attributed to the use of water and salt.

Ultimately, GNIC denied coverage for Mainspring’s loss, explaining that the loss was the result of “poor/inadequate soil preparation and compaction, settlement, and long-term corrosion,” and concluding the loss was within the policy’s inherent-vice, faulty-workmanship, settling, and wear-and-tear exclusions. Mainspring requested that GNIC reconsider the denial.

LAW

Arizona recognizes that all-risk insurance policies cover only fortuitous losses, even if the policy does not expressly say so. Insurance exists to cover risk, not certainty. Because Arizona had not previously defined “fortuitous loss,” the Court adopted the Restatement definition: a fortuitous event is one that, so far as the parties are aware, depends on chance.

ANALYSIS

The Arizona Supreme Court rejected an objective “reasonable foreseeability” test. It reasoned that many insured risks are foreseeable; if foreseeability alone defeated coverage, all-risk insurance would lose much of its purpose.

Instead, the proper test is subjective and focuses on what the insured actually knew when coverage attached.

LACK OF FORTUITY

A loss is not fortuitous merely because the insured knew there was a risk, even a serious one.

It becomes non-fortuitous only if the insured knew the loss-causing event had already occurred, was already underway, or was certain to occur because no meaningful contingency remained.

The Supreme Court also emphasized that insurers can protect themselves through underwriting, premiums, and express exclusions. Courts should not rewrite policies to deny coverage for risks the insurer could have excluded more clearly.
DISCUSSION

The Supreme Court found consistent Arizona insurance law and public policy national authority, especially cases rejecting hindsight-based determinations of inevitability. The Supreme Court disagreed with the Ninth Circuit’s reasoning to the extent it suggested that reasonable foreseeability can make a loss non-fortuitous.

CONCLUSION

The Arizona Supreme Court answered the certified question by holding:

A loss is non-fortuitous only when the insured knew, at the time coverage attached, that the loss-causing event had already occurred, was already in progress, or was certain to occur because no material contingency remained between the facts known to the insured and the loss-causing event.

The standard is subjective, focusing on the insured’s knowledge at the time of contracting — not on hindsight or objective foreseeability.

ZALMA OPINION

When an insured is aware of a risk that would cause an injury or where the injury had already occurred before the inception of the policy, it is not fortutious, was already in progress, or was certain to occur because no material contingency remained.

(c) 2026 Barry Zalma & ClaimSchool, Inc.

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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 ...

00:08:28
August 26, 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 ...

00:08:28
July 22, 2026
The Real Cost of Fraud

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 ...

00:12:33
3 hours ago
Arson for Profit is Ground to Deny Claim

Communications with Arson Investigation is Privileged

Post 5488

Posted on September 11, 2026 by Barry Zalma

ACE Was Not Required To Produce Any Disputed Document Because Each Was Protected By The Attorney-Client Privilege, or The Work-Product Doctrine.

See the full video at and at https://rumble.com/v7fbzvo-arson-for-profit-is-ground-to-deny-claim.html

In Rubesne Resources LLC, a Colorado Limited Liability Company v. ACE Property And Casualty Insurance Company, a Foreign Corporation, Civil Action No. 1:24-cv-02300-DDD-SBP, United States District Court, D. Colorado (August 30, 2026) Rubesne Resources LLC sought insurance coverage from ACE Property and Casualty Company after a January 5, 2024 fire destroyed its business.

South Metro Fire Rescue classified the ignition as intentional, and ACE’s retained expert concluded that gasoline had been poured in multiple areas and ignited. ACE retained coverage and subrogation counsel, National Subrogation Services, and a cause-and-origin expert ...

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3 hours ago

Arson for Profit is Ground to Deny Claim

Posted on September 11, 2026 by Barry Zalma

Communications with Arson Investigation is Privileged

Post 5488

ACE Was Not Required To Produce Any Disputed Document Because Each Was Protected By The Attorney-Client Privilege, or The Work-Product Doctrine.

See the full video at and at https://rumble.com/v7fbzvo-arson-for-profit-is-ground-to-deny-claim.html

In Rubesne Resources LLC, a Colorado Limited Liability Company v. ACE Property And Casualty Insurance Company, a Foreign Corporation, Civil Action No. 1:24-cv-02300-DDD-SBP, United States District Court, D. Colorado (August 30, 2026) Rubesne Resources LLC sought insurance coverage from ACE Property and Casualty Company after a January 5, 2024 fire destroyed its business.

South Metro Fire Rescue classified the ignition as intentional.

After reviewing the disputed documents in camera, the court found that each was protected.

LAW

Colorado Revised Statutes § 10-4-1003 requires ...

September 10, 2026
Failure to Plead a Facially Plausible Claim Requires Dismissal

Referral of Claims to its SIU Is Not Bad Faith

Post 5487

Posted on September 10, 2026 by Barry Zalma

In WIZ Collision, LLC, on behalf of itself and as assignee of Jawara Small, Chester Street LLC, and Aziz Brooks v. GEICO Corporation, No. 25-cv-4201 (KAM)(JAM), United States District Court, E.D. New York (August 28, 2026) Wiz Collision, a New York City auto-body shop, regularly repaired vehicles and submitted insurance claims for customers. It alleged that GEICO repeatedly approved claims and repairs, then referred certain claims to its Special Investigations Unit, stopped issuing payments, and delayed resolution despite ultimately finding no fraud.

Wiz Collision sued on its own behalf and as purported assignee of three customers, asserting contract, good-faith, consumer-protection, and injunctive claims. GEICO removed the case and moved to dismiss under Rule 12(b)(6).
LAW

Under Rule 12(b)(6), a complaint must plead facts supporting a facially plausible claim. Article III standing requires a concrete injury, ...

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