Zalma on Insurance

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An Overview of Insurance Fraud and What is Insurance? Two Video Courses available at https://www.simpliv.com/finance/what-is-insurance and https://www.simpliv.com/finance/an-overview-of-insurance-fraud An Overview of Insurance Fraud Fraud is estimated to take between $80 and $300 billion a year from the property and casualty insurance industry, raising the prices each person pays for insurance by more than $300 Billion a year. This course explains what insurance fraud is and discusses various methods by which insurance fraud is perpetrated. It also…
Claims Handling and Insurance Fraud Adapted from Zalma on Insurance Claims Part 109 Second Edition: A Comprehensive Review of the law and Practicalities of Property, Casualty and Liability Insurance Claims now available  here. Insurance Fraud is Ubiquitous Next to tax fraud, insurance fraud is the most practiced crime in the world. It is perpetrated by members of every race, religion, sexual orientation, and nationality. Insurance fraud is perpetrated by members of every profession. The temptation…
Court Refuses to Allow Pro Se Plaintiff to Annoy Court Insurance criminals who are arrested and convicted of the crime of insurance fraud – a very rare occurrence – can’t believe that they must serve time in jail. As a result of the conviction they insist on filing multiple lawsuits – usually with no merit – just to vex and annoy those who they attempted to defraud and the courts. In Bianca Bucano v. The…
Uberrimae Fidei Ethics is a process of systematically applying, using, defending and recommending concepts of right and wrong behavior. Ethical behavior is required of both parties to a contract of insurance for the system to work. If any party to the insurance contract acts unethically the ability of insurance to work effectively and profitably will fail. Ethics is the essence of insurance. Since insurance was first created it has been a business of utmost good…
Selecting and Working with Counsel Zalma on Insurance Claims Part 108 – Second Edition Adapted from Zalma on Insurance Claims Part 108 -Second Edition: A Comprehensive Review of the law and Practicalities of Property, Casualty and Liability Insurance Claims now available  here. Retaining an Attorney In instances where insurance claims may entail litigation, insurers must move quickly to engage counsel. When an attorney is retained to defend a person insured, the fact should be documented…
Why Subrogation Allows Insurers to Earn Money After Paying a Claim Adapted from Zalma on Insurance Claims Part 107 Second Edition: A Comprehensive Review of the law and Practicalities of Property, Casualty and Liability Insurance Claims now available  here. The equitable doctrine of subrogation places the subrogee in the precise position of the one whose rights are subrogated.[1] Subrogation is the remedy called into existence for the purpose of enabling a party secondarily liable, but…
Zalma’s Insurance Fraud Letter   The Reason for the Examination Under Oath  Zalma’s Insurance Fraud Letter, Volume 23, No. 18 Some of the articles you can read in this issue of ZIFL follow: The Reason for the Examination Under Oath Courts that construe submission to an EUO as a condition precedent to recovery generally do not require the insurer to prove that it suffered actual prejudice from an insured’s unexcused refusal to submit to…
The Compact Books on Adjusting Property or Liability Claims Every business owner, property owner or individual will transfer the risk of loss to an insurer rather than take the risk totally. The transfer is created by the use of insurance policies that protects against contingent or unknown events and damages caused by construction defects. Thorough, yet practical, this series of books form the ideal guide for any professional who works in or frequently interacts with…
Staged Collision not an Accident Those who attempt insurance fraud and are caught will often attempt to disappear rather than litigate to recover for a claim an insurer can prove is fraudulent. Others will sue and attempt to force the insurer into a settlement rather than pay defense costs. In Progressive Northwestern Insurance Co. v. Derrick Burnett, et al., Case No.: 2:18-cv-04243-NKL, United States District Court Western District of Missouri Central Division (August 27, 2019)…
The Basic Investigation Required to Evaluate a Claim Adapted from Zalma on Insurance Claims Part 107 Second Edition: A Comprehensive Review of the law and Practicalities of Property, Casualty and Liability Insurance Claims now available  here. The evaluation of a first party property claim always involves: A determination of the actual cash value (ACV) of property the risk of loss of which was insured. ACV is defined as: replacement cost less physical depreciation; fair market…