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Latest from Zalma on Insurance

The Defects See the full video at https://youtu.be/sANuuIPQmaA Construction defects are any deficiencies in the performance or completion of the design, planning, supervision, inspection, or construction for any new building or structure that has been remodeled or undergone repairs. Understanding what a construction defect is has become so complex that states have begun to define them by statute. For example, construction defects are defined as a “violation of statutory performance standards for every building component…
Insurer has no Obligation to Investigate Change of Beneficiary It has often been said that where there is a will there are relatives & their lawyers. The same type of dispute arises when the beneficiary and owner of a life insurance policy changes shortly before the death of the life insured. In Emery v. Guarantee Trust Life Insurance Company, A20A2082, Court of Appeals of Georgia (January 22, 2021) Georgia was faced with a claim by…
From Barry Zalma, Esq., CFE Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921 including more videos than listed here; A Video Explaining the Requirement For Insured To Reside At The Residence Premises A Video Relating to Domicile v. Residence in Insurance Claims A Video Explaining Insured Should Not Take “The Fifth” The Creation of Insurance and the Ethical Insurer A Video Explaining the False Swearing Defense to an Insurance Claim A Video Explaining
Standardized Construction Contracts and Insurance Claims See the full video at https://youtu.be/VNMVChK-bMk Purchasing a standardized and industry-accepted form is less expensive than asking an attorney to draft a specific contract from scratch, although on a large project, it is often a good idea to involve counsel to review and/or modify the standardized forms to protect the client’s interests. Generally though, sources that create construction contracts are equipped to protect standardized form users because they are…
Insurance Fraud Victims Who Get no Justice from State May Sue Fraud Perpetrators on Behalf of State The California Legislature created the Insurance Fraud Protection Act (IFPA) to combat insurance fraud. When, as here, a private insurance company contracts with a surgical center to provide medical services for its insureds the contract contains an arbitration clause to settle disputes. However, the insurance company brought a qui tam action to recover damages and fees occasioned by…
There is no Coverage Under a Homeowners Policy if the Insured Does Not Actually Live There See the full video at https://youtu.be/nXnfpM-oLxE The homeowners policy language unambiguously requires that the property at issue be the insured’s “residence premises” for coverage to apply. It does not require that the property be the Insured’s domicile. The “insured location” was defined in relevant part to mean “the residence premises,” and the “residence premises” was defined to mean the…
­­­­­The Marine Rule Requires Rescission of a Marine Policy Because of Concealment of Material Fact Carlos Morales-Vázquez (Morales) purchased a policy of marine insurance without disclosing, among other things, a prior grounding. His insurer, QBE Seguros, when it learned the true facts sued to confirm rescission because of the concealment of material facts. In QBE Seguros v. Carlos A. Morales-Vázquez, No. 19-1503, United States Court of Appeals For the First Circuit (January 19, 2021) the…
Domicile or Residence of Insured or Insurer See the full video at https://youtu.be/X94jiAiWabA Insurance companies often see disputes relating to the terms “domicile” and “residence.” It is important, therefore, that everyone in the business of insurance must understand the meaning, and application, of the terms to insurance claims and how they relate to individuals and corporations that are insured or insurers. Definition of Domicile Although a person may have more than one residence, he or…
Proof of Failure to Appear for EUO is Sufficient to Void Coverage and Defeat Claims of Health Care Providers In a declaratory judgment action, the plaintiff moved for summary judgment against defendants New York City Health and Hospitals d/b/a Queens Hospital Center et al. The plaintiff sought a declaration that it is not obligated to pay no-fault benefits to it to reimburse the defendants for claims made under insurance policy number RS813817617, claim number 329138-001,…
Insurance Contracts Must Be Read as They are Written People injured in an accident where the tortfeasor’s insurer refuses to provide a defense or indemnity have two choices: (1) rely on the tortfeasor’s assets to indemnify the injured or (2) enter into an agreed judgment with the tortfeasor, agree to a covenant not to execute on the judgment and take an assignment of the tortfeasor’s rights against the insurer. Both options are gambles. However, greed…