قالب وردپرس درنا توس
Home / Insurance / Give yourself a gift with insurance advice for the new year

Give yourself a gift with insurance advice for the new year



For the past 53 years, Barry Zalma has devoted his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to enable insurers and their claims staff to become professionals in insurance claims.

Fictional true crime stories about insurance fraud from an expert who explains why insurance fraud is a "Heads I Win, Tails You Lose" for insurance companies.

The stories help to understand how insurance fraud in America costs thousands of dollars every year who buy insurance and why insurance fraud is safer and more profitable for the perpetrators than any other crime.

This book began as a collection of columns that I wrote and published in the Insurance Journal, Insurance Week, and The John Cooke Insurance Fraud Report, insurance industry publications that serve the insurance community in the United States. Since the last issue, I have added more stories that were published in my newsletter twice a month, Zalma's insurance fraud letter which is available for free to anyone who clicks on the links.

Available as a Kindle Book and available as a paperback book from Amazon.com.

California SIU Regulations 2020 is designed to assist California insurance claims personnel, claims personnel, independent insurance adjusters, special fraud, private investigators working for the insurance industry, industry management, attorneys serving the industry, and all integrated California anti-fraud companies and compliance officers. the requirements of the California SIU Claims Regulations, which were rewritten and entered into force on October 1

, 2020.

The State of California, by law, requires all authorized insurers to maintain a special investigative unit (a "SIU") that meets the requirements of the SP Investigation Regulations ( "SIU Regulations") and train all integrated anti-fraud staff to recognize insurance fraud indicators. It is therefore necessary for insurance personnel who work in any way to present, process or negotiate insurance claims in California to be familiar with the SIU regulations.

The state has assumed all responsibility for personnel to deal with insurance fraud if the insurers do business in the state. California Licensed Insurance Companies are required by California Insurance Code Sections 1875.20-24 and California Code of Regulations, Section 10, Sections 2698.30 -.41 to establish and maintain special investigative units that identify and refer suspected insurance fraud to the California Department of Insurance (CDI) and directly to the local California County District Attorney & # 39 ;s Office for employee compensation only. The rules also require each insurer to submit an SIU annual report to the CDI that provides important information about the insurer's SIU fraud prevention, procedures, and training materials. The SIU review program evaluates the report's accuracy, completeness and timeliness. The reports are used to carry out a risk assessment to determine which insurers are selected for review of SIU compliance. R

The appendices contain outlines to be used by an employee of the insurance company SIU, its trainers, teachers or lawyers to present a training class for all "integrated anti-fraud staff" with the insurers as defined in the SIU regulations. The insurers must understand that all non-life employees must be trained in accordance with the requirements in the SIU regulations no later than 30 days after the person is employed and thereafter annually. Because it is not economically reasonable to train a new employee, the California SIU Regulations 2020 camera provides the training needed at no extra cost to one or two people for a training class. California's SIU Regulations 2020 and its annexes will provide the insurer and its personnel with the information needed to comply with the SIU Regulations and will provide the training required for what the SIU Regulations describe as an insurer's integrated fraud prevention personnel. '

Available as a Kindle book here.

Available as a paperback book here.

In 1993, after waiting five years after receiving guidance from the California Supreme Court, the State of California ruled that the insurance industry must be regulated to prevent insurers from treating the insured badly. and without good faith. It created a set of regulations called the "California Fair Claims Settlement Practices Regulations" ("Regulations") that were designed to enforce the mandate created under the California Fair Claims Settlement Practices Charter, California Insurance Code section 790.03 (h). in response to the direction of the California Supreme Court in its decision, Moradi-Shalal v. Fireman & # 39; s Fund Ins. Company, 46 Cal. 3d 287 (1988).

 California Fair Settlement Agreement Rules 2020: Reasons Why the California Department of Insurance Introduced the Fair Claims in California ... Transfer Rules for All Insu of [Barry Zalma] This is how the California Department of Insurance (CDOI) issued rules that were designed to micro-handle insurance claims and create a method for punishing insurers who did not comply with the regulations. Some of the regulations recited what had always been recognized by the insurance industry as good faith and proper claims handling. Others introduced draconian mandates for what and when to do everything in the damage process.

The regulations also provided a guide to insured, general insurance adjusters and policyholders' attorneys to allege any violations of the regulations as evidence that the insurer is violating the implied union of good faith and fair trade.

Reason for This Book

This book was designed to help insurance businessmen in the state of California.

It will advise:

• all staff in insurance claims,
• professionals,
• independent insurance adjusters,
• special fraud investigators,
• private investigators working for the insurance industry,
• the management of
• lawyers who serve the industry,
• general insurance adjusters,
• policyholders and
• advice to policyholders working with insurance companies doing business in California
in information needed to correctly, efficiently and fairly resolve insurance claims.

All insurance companies operating in California must meet the requirements of the regulations or face CDOI quarrels and attempted financial penalties. That sentence was found to be dubious and limited due to a brave insurer who fought against the CDOI and succeeded before a judge in the administrative court who limited the right to punishment. As far as I have been able to determine, that success has not been imitated.

Notwithstanding the difficulty of assessing punishment, the State of California requires anyone involved in the litigation process – even if only tangential – to be trained in the handling of damages in accordance with the regulations and certify that such training has been completed under oath. To avoid the required annual training, the injured party may submit a difficult document to the insurer or insurers for whom the injured party works which prevents him or her from reading and understanding the regulations.

Review of this book, the regulations and the comments below should be sufficient to meet the training requirements of the regulations.

It is necessary that insurance personnel who are in any way involved in the presentation, processing or negotiation of insurance claims in California be familiar with the regulations. Advisers for insurers and policyholders should also be familiar with the regulations as they set a minimum standard for claims management in the state.

There is also an overview for an education in the appendix.

Available as a paperback [19659003] Available as a Kindle Book

 Zalma's Mold and Fungus Handbook: Understanding Mold, Fungal and Bacterial Infections and What to Do About Them. by [Barry Zalma] This book is the latest addition to Barry Zalma's series of books and articles that are the most thorough, up-to-date, expertly written guides available today on structural damage and human damage from mold, fungi, bacteria or viral infections.

Zalma's mold and fungus manual deals specifically with issues related to mold, fungi and bacterial infections and provides a detailed examination of the substances, their potential for property damage and bodily harm.

Written by nationally known insurance and insurance protection expert, Barry Zalma, a semi-retired insurance protection lawyer, insurance consulting consultant, insurance protection expert witness, author, video blogger and blogger. Zalma's mold and fungus manual provides in – depth explanations, analyzes, examples and a detailed discussion of:

• mold;
• mushrooms;
• bacteria;
• claims for mold, fungi and bacteria; and
• Mold, fungal and bacterial disputes.

This book is thorough, yet practical, the perfect guide for any property owner, professional who works in or often interacts with repair or decontamination of mold, fungus or ba cteria infested property. It is also useful for all insurance policy, sales or claims professionals and all lawyers who are involved in the construction industry or who are involved in construction disputes involving mold, fungus or bacterial infections. Entrepreneurs, whether they own or rent real estate, will benefit greatly from The Mold and Fungi Handbook. It is the perfect resource for insurance educators, educators and students whose role requires an understanding of mold, fungus and bacterial infections.

The author has provided checklists and information and references to statutes involved in mold, fungi or bacteria. [19659003] This, Zalma's mold and fungus manual was written to help anyone facing property damage or bodily injury as a result of exposure to mold, fungus or bacterial infections. It was also written to help with the presentation of claims to tortfeasors and insurers for damage to property or persons.

Kindle Edition

Paperback Edition

by Barry Zalma, Esq., CFE

Learn techniques that can help you interact with others and effectively gather the facts you need.

The purpose of an interview is to reveal the truth; the method of revealing the truth is the interview. Obtaining sufficient relevant information is imperative in anything a lawyer does to protect the client's interests, but interview techniques are not emphasized in law school education.

Getting the Whole Truth Advocates – from novices meeting their first clients to experienced litigation attorneys – teach effective methods of obtaining information through human interaction. No matter who you are looking for information or what your reason for wanting it, these techniques can help you meet and interact with others and effectively gather the facts you need.

$ 59 NON-MEMBERS, $ 44 MEMBERS

A tool available to insurers to thoroughly investigate claims and work to combat fraud

A tool available to insurers to thoroughly investigate claims and work to defeat fraud .

The insurance survey under oath ("EUO") is a formal type of interview approved by an insurance contract. It is taken under the authority provided by the insurer's agreement, when he or she acquires an insurance policy, to submit to a condition of the insurance contract which compels the insured to appear and give a hard testimony at the request of the insurer. Failure to appear and testify is considered a violation of a material condition.

EUO is performed in front of a notary and a certified stenographer reporter who is present to take the oath to the interviewee. The reporter will record the entire conversation and prepare a transcript to be read, reviewed, corrected and signed by the witness under penalty of perjury or by an oath taken by a notary or judge. insurance companies in the United States. A professional insurer will only require an insured person to file an EUO when a thorough claim gives rise to questions:. About the application of coverage to the facts of the loss, the possibility of attempted fraud, or to assist the insured to the obligation to prove to the insurer the cause and magnitude of the loss.

Although EUO is rarely used, it is an important tool that insurers need when it comes to coverage, destruction of evidence needed to prove a compensable loss or the size of loss or evidence that indicates the risk of attempted fraud. The provisions of the EUO and legal measures in an insurance are conditions for an insured's ability to bring an action and that since the insured has not substantially complied with the terms of these provisions, the appropriate remedy is termination without affecting it. The insured's failure to meet these conditions does not prevent his ability to incur a cost of recovery, but only interrupts his ability to bring a suit until he has fully complied with these conditions.

Available as a paperback book Available as a Kindle book here

HOW TO BUY A PERSONAL HOUSEHOLDER POLICY AND SUCCESSLY MAKE A CLAIM TO THE INSURER

Insurance is an agreement between an insurance company and an insurance company. It is obtained by contacting the insurer as a potential insured seeking insurance. The household policy is a specialized insurance policy that protects the homeowner from certain risks of loss of real and personal property in the home, the exposure that the insured faces to damage to a household employee and the insured's exposure to liability for bodily injury or property damage caused by third parties. The book explains how to purchase a homeowners policy and how to collect any claims made to the homeowners insurer.

Paperback Book Kindle Book

Ten volumes consisting of a comprehensive set of materials for property and accident insurance claims

Insurance claims professional and expert witness Kevin Quinley about the following ten volumes: “Zalma's series of books are a fantastic mix of both the the legal basis and the practical consequences for the claimant. "

Insurance Maven Bill Willson said: “& # 39; Zalma On Insurance Claims & # 39; is a tour force, an indispensable tool that should be part of every injury training program in America and in the library for all professionals for quick and frequent reference. This comprehensive guide belongs to the library for each insurance defense AND policyholder law firm. It should be part of every training program for transport vehicles, independent adjustment companies and public adjusters. Many of these elements should be included in training or reference programs for staff without requirements, from agents to insurers to risk managers.

This series of books is the latest addition to Barry Zalma's insurance claims series with books and articles that will be the most thorough, up-to-date, expertly written guide to insurance claims available today.

This accurate, yet practical series of books is the perfect guide for any professional who works in or often interacts with the insurance industry. . Claims, risk managers, producers, insurers, lawyers (both complaints and defense) and entrepreneurs will benefit greatly from the ten volume guide. It is also the perfect resource for insurance educators, educators and students whose role requires an understanding of insurance law. A Comprehensive Review of insurance, insurance claims, the law of insurance policy interpretations, the praktical of Property, Incidently and Liability Insurance Claims.

Zalma on Insurance Claims Volume 101 – Second Edition

A Comprehensive Review of insurance, insurance claims, law on insurance and interpretation of insurance etation Paperback – 17 July 2019 [19659003] This volume covers

  1. WHAT IS INSURANCE?
  2. HISTORY OF INSURANCE,
  3. ACQUISITION OF POLICY,
  4. REQUIREMENT OF PERSONNEL,
  5. KIND OF INSURANCE POLICY,
  6. LIABILITY POLICY.

The author has provided checklists, test procedures, form letters, tables and information and references to model bylaws, state bylaws, administrative regulations and requirements for insurance departments throughout the country.

Available as paperback

Available as a Kindle Book

Zalma on Insurance Claims Part 102 – Second Edition

This second edition of the second volume in the latest addition to Barry Zalma's series of books and articles on insurance claims is part of the most thorough, up-to-date, expertly written insurance claims guide available today. Zalma on Insurance Claims, Part 102 provides in-depth explanations, analyzes, examples and detailed discussion of: • Other insurance clauses; • Trigger of Coverage; • Insurance • Terms, Guarantees and Exemptions

The author has provided checklists, test procedures, form letters, tables and information and references to model statutes, government statutes, administrative regulations and requirements for insurance departments across the country.

Available as a Kindle book

Available as a paperback book

The Implied Covenant of Good Faith and Fair Dealing

The principle that insurance has existed for the last three to four centuries is that insurance business conducted with the greatest good faith (uberrima fides). The principle, called a union of good faith and fair trade, must be followed religiously by both the insurer and the insured. This simply means that both parties to the insurance contract must treat each other in such a way that neither deprives the other of the benefits of the contract.

This, the third part of Zalma on insurance claims and contains material relating to:
This is part 103 of Zalma on insurance claims and will deal with:

• The agreement on good faith and fair treatment
• The obligations of the insured and the insurer
• Explain that an insurance expires
• Treatment of a claim
When read with part 101 and part 102, this volume works to take the reader to a complete understanding of the insurance and insurance claims.

Available as a Kindle Book

Available as Paperback

Zalma on Insurance Claims Part 104

This, the fourth part of Zalma on Insurance Claims and contains material relating to:

  1. Examination of first party damages
  2. Revocation
  3. Loan clause
  4. Fortuit y & other issues
  5. Determine the size of the loss
  6. Damage file

When read with part 101, part 102 and part 103, this volume works to take the reader to a complete understanding of insurance and insurance claims.

Available as a Kindle Book

Available as a paperback book

Zalma on Insurance Claims Part 105

This, the fifth part of Zalma on Insurance Claims and includes material concerning:

  1. Investigation – Responsibility
  2. Claims made and reported policies
  3. The rule on notification of prejudice.
  4. Types of damages
  5. Liability file
  6. Discovered by the archive of insurance claims
  7. Tests to determine the duty to defend
  8. Appendices – form for the injured party

When read with insurance 101, insurance 102, insurance 103 and 104, this volume works to take the reader to a complete understanding of insurance and insurance claims.

Available as a Kindle Book

Available as Paperback

Zalma on Insurance Claims Part 106 Second Edition

A Comprehensive Review of the Law and Practicalities of Property, Incidented and Liability Insurance Claims Paperback [19659107] This latest addition to Barry Zalma's series of books and articles on insurance claims is part of the most thorough, up-to-date, expertly written insurance guide available today. Written by the nationally recognized insurance coverage expert Barry Zalma, an insurance lawyer, lawyer, consultant, expert witness and blogger.

This book is thorough, yet practical, the perfect guide for any professional who works in or often interacts with the insurance industry. Claimants, risk managers, producers, insurers, lawyers (both plaintiffs and defense) and entrepreneurs will benefit greatly from this multi-volume guide. It is also the perfect resource for insurance educators, educators and students whose role requires an understanding of insurance law.

The author has provided checklists, test procedures, form letters, tables and information and references to model statutes, state statutes, administrative rules and requirements for insurance departments across the country.

This is the sixth part of "Zalma on Insurance Claims" and will deal with:

  1. Property Insurance & Damage on Bad FaithChapter
  2. Grounds for Finding Bad FaithChapter [19659065] Avoiding Accusations of Bad FaithChapter
  3. Bad faith and liability insurance.
  4. Defense against the damage of bad faith

The appendices also contain full text with important insurance laws and statutes

Available as a Kindle book

Available as paperback

Zalma on Insurance Claims Part 107 – Second Edition [19659120] This is the seventh part of "Zalma on Insuranc e Claims" and will deal with:

1.Evaluation and Settlement – Property
2.Evaluation and Settlement – Liability
3. Subrogation
4. Salvage

When read with Part 101, Part 102, Part 103, Part 104, Part 105 and Part 106 this volume works to take the reader to a complete understanding of insurance and insurance claims.

Available as a Kindle book

Available as paperback

Zalma on Insurance Claims Part 108 – Second Edition

This, the eighth part of Zalma on Insurance Claims, contains material relating to: [19659003] 1. Preparing a case for trial
2. Interview technician
3. Interview art
4. Interview general principles
5. The interviewer
6. Preparing for the interview
7. Starting the interview
8 Control of the interview
9. Handling of witness types
10. Approaching the work
11. Handling of t he nervous person
12.Bluffs
13.The mutability in memory
14.The investigation during ed

When read with Part 101, Part 102, Part 103, Part 104, Part 105, Part 106 and Part 107 this volume works to take the reader to a complete understanding of insurance and insurance claims.

Available as a Kindle Book

Available as a Pocket Book

Zalma on Insurance Claims Part 109 Second Edition

This, the ninth part of Zalma on insurance claims, contains material relating to:

Identifying insurance fraud
Professional conspiracies
Several types of insurance fraud
How to Join the fight against fraud
Case studies of successful fraud 1945 investigations Insurance Frauds
Checklist 2 – Educators
Checklist 3 – Red Flags of Fraud – Property Insurance
Checklist 4 – Red Flags of Fraud – Liability Insurance
Appendix A – Common Medical Acronyms – Glossary and Glossary of Medical Terms

When Reading Part 101, Part 102, Part 103, Part 104, Part 105, Part 106, Part 107 and Part 108 this volume works to take the reader to a complete understanding of insurance and insurance claims.

Available as a Kindle book

Available as a paperback book

Zalma on Insurance Claims Part 110 Second Edition

This, the tenth part of Zalma on insurance claims, contains material regarding:

Answer on fraud
Grounds for revocation.
The Fight Against Fraud
Checklist 1 – Replies to Frauds
Checklist 2 – The Fight Against Fraud

When read with Part 101, Part 102, Part 103, Part 104, Part 105, Part 106, Part 107, Part 108 and Part 109 work this volume to take the reader to a complete understanding of insurance and insurance claims.

Available as a Kindle book

Available sm as a paperback book


  Construction Defects and Insurance Volume One: The Structure, The Construction Contract, and Construction Defect Insurance Barry Zalma has updated and reworked his groundbreaking work [19659144] Construction Defects Coverage Guide in is the latest addition to Barry Zalma's insurance claims series with books and articles that will form the most thorough, up-to-date, expertly written insurance claims guide available today eight Kindle or Paperback Volumes at reasonable prices.

Thorough, yet practical, this series of books is the perfect guide for any professional who works in or often interacts with the insurance industry.

Claims professionals, risk managers, producers, insurers, lawyers (both plaintiffs and defense) and entrepreneurs will benefit greatly from the ten volume guide. It is also the perfect resource for insurance educators, educators and students whose role requires an understanding of insurance law.

The eight volumes include:

Volume one: The structure, construction contract and construction defect Insurance – Kindle book; Paperback

Volume two: Defects and Understanding insurance and insurance – Kindle book; Pocketbok

Volume three: C onstruction Defect Policies – Kindle book; Paperback

Volume four: Liability insurance. – Kindle Book; Pocketbok

V olume Five: Tort of Bad Faith and Construction Defects – Pocketbok

Volume sex: Construction Defect Costumes – Kindle book; Paperback

Volume seven: T place defense and the trial against a design flaw – Kindle Book; Paperback.

Volume Eight: Evaluation and Resolution & Alternative Dispute Resolution – Kindle Book; Pocket Book


This series of books is the latest addition to Barry Zalma's series of insurance claims with books and articles that will be the most thorough, up-to-date, expert-written guide to insurance claims available today.  Mold Claims Volume One: Understanding Insurance Claims and Disputes Regarding Mold, Fungal and Bacterial Infections.

Written by nationally known insurance expert Barry Zalma, a half-retired insurance lawyer, consultant, expert witness and blogger, Mold Claims provides in-depth explanations, analyzes, examples and detailed discussion of:

  1. Mold;
  2. Fung  Mold claims Volume two: Understand insurance claims and disputes regarding mold, fungal and bacterial infections. i;
  3. Bacteria;
  4. Mold,
  5. fungal and bacterial requirements; and
  6. Mold, fungus, bacteria disputes.

Thorough, yet practical, this series of books is the perfect guide for any professional who works in or frequently interacts with the insurance industry or is involved in disputes. Claimants, risk managers, producers, in-depth  Mold claims Volume three: Understand insurance claims and disputes regarding mold, fungal and bacterial infections. ritörer, advokater (både kärande och försvar) och företagare kommer att gynnas mycket från formvolymerna. Det är också den perfekta resursen för försäkringsutbildare, utbildare och studenter vars roll kräver förståelse för försäkringslagstiftningen när det gäller mögel, svampar och bakterieinfektioner.

Autho  Mögelkrav Volym fyra: Förstå försäkringsanspråk och tvister angående mögel-, svamp- och bakterieinfektioner. r har tillhandahållit checklistor, provförfaranden, formulärbrev, tabeller och information och referenser till modellstadgar, statliga stadgar, administrativa bestämmelser och krav från försäkringsavdelningar över hela landet.


Lagen om oavsiktliga konsekvenser och skadan om dålig tro

Begreppet oavsiktliga konsekvenser är en av byggstenarna i ekonomin. Adam Smiths "osynliga hand", den mest kända metaforen inom samhällsvetenskap, är ett exempel på en positiv oavsiktlig konsekvens.

Oftast belyser dock lagen om oavsiktliga konsekvenser de perversa oväntade effekterna av lagstiftning och reglering. År 1692 uppmanade den engelska filosofen John Locke, en föregångare till moderna ekonomer, nederlaget för en parlamentarisk proposition

att sänka den högsta tillåtna räntan från 6 procent till 4 procent. Försäkringen kontrolleras av domstolarna, genom överklagandebeslut och av statliga myndigheter, genom lagar och regler. Överensstämmelse med överklagandebeslut, stadgar och förordningar – olika i olika stater – är oerhört svårt och dyrt.

Försäkringsverksamheten är tyvärr underkastad lagen om oavsiktliga konsekvenser som om det vore för steroider. [19659003]Available as a paperback  

Available as a Kindle book

Insurance Fraud – Volume I & Volume II

In Two Volumes

Insurance fraud continually takes more money each year than it did the last from the insurance buying public. No one knows the actual amount with any certainty because most attempts at insurance fraud succeed. Estimates of the extent of insurance fraud in the United States range from $87 billion to more than $300 billion every year.

Insurers and government backed pseudo-insurers can only estimate the extent they lose to fraudulent claims. Lack of sufficient investigation and prosecution of insurance criminals is endemic. Most insurance fraud criminals are not detected. Those that are detected do

so because they became greedy, sloppy and unprofessional so that the attempted fraud becomes so obvious it cannot be ignored.

No one will ever be able to place an exact number on the amount lost to insurance fraud. Everyone who has looked at the issue knows – whether based on their heart, their gut or empirical fact determined from convictions for the crime of insurance fraud – that the number is enormous.

When insurers and governments put on a serious effort to reduce the amount of insurance fraud the number of claims presented to insurers and the pseudo-government-based or funded insurers drops logarithmically. Since the appointment of Attorney General Sessions, the effort to stop insurance fraud against Medicare and Medicaid has increased.

This book contains appellate decisions regarding insurance fraud from federal and state appellate courts across the country and full text of many insurance fraud statutes.

It is available as both a legal research tool and a product to assist insurers, insurance company personnel, independent insurance adjusters, special investigation unit investigators, state fraud investigators and insurance lawyers to become effective persons involved in the attempt to defeat or reduce the effect of insurance fraud.

Volume One available as a Kindle book and a paperback.

Volume Two Available as a Kindle book and a paperback

The Compact Book of Adjusting Property Insurance Claims – Second Edition

A Manual for the First Party Property Insurance Adjuster

The insurance adjuster is not mentioned in a poli cy of insurance. The obligation to investigate and prove a claim falls on the insured. Standard first party property insurance policies, based upon the New York Standard Fire Insurance policy, contain conditions that require the insured to, within sixty days of the loss, submit a sworn proof of loss to prove to the insurer the facts and amount of loss.

The policy allows the insurer to then, and only then, respond to the insured’s proof of loss. The insurer can then either accept or reject the proof submitted by the insured.

The Compact Book of Adjusting Property Claims -- Second Edition: A Primer For The First Party Property Claims Adjuster.Technically, if the wording of the policy was followed literally the insurer could sit back, do nothing, and wait for the proof. If the insured was late in submitting the proof the insurer could reject the claim. If the insured submits a timely proof of loss the insurer could either accept or reject the proof of loss. If the insurer rejected the proof of loss the insured could either send a new one or give up and gain nothing from the claim. Suit on the policy would be difficult because the policy contract limited the right to sue to times when the proof of loss condition had been met.

Insureds and insurers were not happy with that system. It made it too difficult for a lay person to successfully present a claim. The system, as written into the standard fire policy seemed to run counter to the covenant of good faith and fair dealing that had been the basis of the insurance contract for centuries. Most insurers understood that their insureds were mostly incapable of complying with the strict enforcement of the policy conditions. To fulfill the covenant of good faith and fair dealing insurers created the insurance adjuster to fulfill its obligation to deal fairly and in good faith with the insured.

The Second edition adds new material from 2018 and 2019, is easier to use and more compact than the original.

Available as a Kindle book.

Available as a paperback.

The Compact Book on Adjusting Liability Claims, Second Edition

A Handbook for the Liability Claims Adjuster

This Compact Book of Adjusting Liability Claims is designed to The Compact Book Of Adjusting Liability Claims Second Edition: A Handbook for the Liability Claims Adjusterprovide the new adjuster with a basic grounding in what is needed to become a competent and effective insurance adjuster. It is also available as a refresher for the experienced adjuster.

The liability claims adjuster quickly learns that there is little difficulty with a claimant (the person alleging bodily injury or property damage against a person insured) if the claim is paid as demanded. The insured may be unhappy if the claimant’s claim is paid as presented since most do not believe they did anything wrong or fear an increase in premiums charged for subsequent policies.

The adjuster must be prepared to salve the insured’s emotions, explain why in the law and the policy it was appropriate to pay the claimant and that the settlement is in the best interest of both the insured and the insurer the adjuster represents.
The adjuster knows, and must be prepared to explain to an insured, that if a claim is resisted or denied the claimant will be unhappy, will probably file suit. If not promptly settled the claimant’s lawyers will rake the insured over the coals to prove that the insured is liable for the claimant’s injuries. The litigation will take time, effort, and money to establish the extent of the injuries and who is responsible for the injuries. Failure to settle promptly can cost the insured his or her reputation and will certainly cost the insurer much more than the claim could have been resolved for had it been resolved before the claimant retained a lawyer.

Available as a Kindle book

Available as a paperback.

Ethics for the Insurance Professional – Second Edition

How the Covenant of Good Faith and Fair Dealing Requires Ethical Insurance Representatives

Insurance is, by definition, a business of the utmost good faith. This means that both parties to the contract of insurance must act fairly and in good faith to each other and do nothing that will deprive the other of the benefits the contract of insurance promised.

Without the covenant of good faith and fair dealing and ethical people who work in the insurance industry applying and fulfilling the covenant, insurance is impossible. One cannot act fairly and in good faith without being a person with a well-formed ethical compass.

In Carter v. Boehm S.C. 1 Bl. Burr 1906, 11th May 1766. 593, 3 Lord Mansfield in the British House of Lords stated: “Good faith forbids either party by concealing what he privately knows, to draw the other into a bargain, from his ignorance of that fact, and his believing the contrary.” Insurers, when making a decision to insure or not insure a risk, rely on the information provided to them by the insured. As Lord Mansfield instructed, the insured must provide the information requested honestly and in good faith.

The implied covenant explains that no party to a contract of insurance should do anything to deprive the other of the benefits of the contract.

The implied covenant of good faith and fair dealing imposes obligations not only as to claims by a third party but also as to those by the insured. When the insurer unreasonably and in bad faith withholds payment of the claim of its insured, it is subject to liability in tort. For the insurer to fulfill its obligation not to impair the right of the insured to receive the benefits of the agreement, it again must give at least as much consideration to the latter=s interests as it does to its own.

Therefore, since, at least 1766, the business of insurance is a business of the utmost good faith, that is, each party to a contract of insurance must deal with each other ethically. The general duty of good faith and fair dealing incorporated by reference into every policy of insurance requires a complete understanding of ethics and ethical behavior.

In every insurance contract there is an implied covenant of good faith and fair dealing that neither party will do anything which will injure the right of the other to receive the benefits of the agreement.

Available as a Paperback   

Available as a Kindle Book.

The Little Book on Ethics for the American Lawyer

The practice of law demands more than knowledge of statutory and case law. It requires more than technical proficiency in the nuts and bolts of legal practice. A lawyer is an officer of the legal system whose conduct should conform to the requirements of the law, both in professional service to clients and in the lawyer’s business and personal affairs.

The practice of law requires that every lawyer treat each client, each adversary, and the court ethically and in good faith.

The practice of law is different from other professions because it requires that the lawyer act for his or her client, not him or herself, only if the actions for the client are ethical and in good faith.

What is Ethical Behavior?

The concept of ethical behavior refers to well-founded standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues, all of which are essential to the lawyer.

Ethics, for example, refers to those standards that impose the reasonable obligations to refrain from murder, rape, theft, assault, sla nder, and fraud. Ethical standards also include those that imply virtues of honesty, compassion, and loyalty.

There are rights presumed to exist such as those described in the Declaration of Independence submitted to King George of England in 1776 that held: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of happiness.” The unalienable rights also include the right to life, the right to freedom from injury, and the right to liberty. Such standards are adequate standards of ethics because they are supported by consistent and well-founded reasons.

Ethics, for example, refers to those standards that impose the reasonable obligations to refrain from murder, rape, theft, assault, slander, and fraud. Ethical standards also include those that imply virtues of honesty, compassion, and loyalty.

There are rights presumed to exist such as those described in the Declaration of Independence submitted to King George of England in 1776 that held: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of happiness.” The unalienable rights also include the right to life, the right to freedom from injury, and the right to liberty. Such standards are adequate standards of ethics because they are supported by consistent and well-founded reasons.
Ethics also refers to the study and development of one’s standards of conduct.

Feelings, laws, and social norms can deviate from what is ethical. It is necessary, especially to people involved in the practice of law, to constantly examine one’s standards to ensure that they are reasonable and well-founded conduct that ethically treats a client, an adversary, and the court with the utmost good faith.

There is no single answer to the question of what is ethical behavior by a lawyer. Ethical behavior is subjective and fact dependent.

Available as a Kindle book here.

Available as a paperback here.

Rescission of Insurance – 2nd Edition

Newly updated and expanded, “Rescission of Insurance – 2nd Edition” provides the insurance coverage lawyer, policyholder lawyer and claims professionals with everything needed to understand and enforce the equitable remedy of rescission. Everyone involved in or with the business of insurance must understand that rescission is an equitable remedy as ancient as the common law of Britain. When the United States was conceived in 1776 the founders were concerned with protecting their rights under British common law. They adopted it as the law of the new United States of America modified only by the limitations placed on the central government by the U.S. Constitution approved in 1789.

The viability and ability to enforce contracts was recognized as essential to commerce. Courts of law were charged with enforcing legitimate contracts. Courts of equity were charged with protecting contracting parties from mistake, fraud, misrepresentation and concealment since enforcing a contract based on mistake, fraud, misrepresentation or concealment would not be fair. The common law developed rules that courts could follow to refuse to enforce the terms of a contract that was entered into because of mutual mistake of material fact, a unilateral mistake of material fact, the breach of warranty (a presumptively material promise to do or not do something), a material concealment, or a material misrepresentation. The remedy – called rescission – created a method to apply fairness to the insurance contract and allow an insurer to void a contract and allowed courts to refuse to enforce such a contract entered into by misrepresentation or concealment of material facts.

Available as a paperback.

Available as a Kindle book.

After more than 53 years acting as a claims person and insurance coverage lawyer I enjoy reading court decisions concerning insurance. The idea of this blog is to find new cases that are interesting to me and then write a summary. Some of the cases reviewed will be important. Some may be of first impression. Others will be totally unimportant. All will be interesting.

The case digests and articles from 2010 to the present, now in elenven volumes, where I digest cases published by courts of the various states and the United States.

The court decisions have been modified from the actual language of the court decisions, were condensed for ease of reading, and convey the opinions of the author regarding each case.

Available as a paperback.

Available as a Kindle book.


Fictionalized True Crime Stories of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.

The stories 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 book started as a collection of columns I wrote and published in the magazines “Insurance Journal,” “Insurance Week, ” and “The John Cooke Insurance Fraud Report” insurance trade publications serving the insurance community in the United States. Since the last edition I have added more stories that were published in my twice monthly newsletter, Zalma’s Insurance Fraud Letter which is available free to anyone who clicks the links.

The original title was “Heads I Win, Tails You Lose” and was meant to describe insurance fraud as it works in the Unites States. It means that whenever a person succeeds in perpetrating an insurance fraud everyone who buys insurance is the loser. If the fraud succeeds the insurer must charge more premium to cover the expense of defending the fraud and payment of funds to the fraud perpetrator. If the fraud fails the insurer must charge more premium to cover the expense of defending the fraud. Everyone, except the lawyers, lose.

As you read the stories I hope they help you understand the effect that insurance fraud has on the perpetrators, the insurers, the people who need insurance, the people who buy insurance, and the people who keep the promises made by insurance policies.

Available as a Kindle Book and Available as a Paperback from Amazon.com.

Product Details

How a young lawyer and wise old investigator defeated an attempt at life insurance fraud.

Available as a Kindle Book.

Available as a paperback.

Murder And Insurance Fraud Don’t Mix

My name is Marion Orpheus Montague. My friends, and some enemies, call me “MOM.” It is not a designation of my ability to nurture my clients. I have never been, nor will I Product Detailsever be, maternal. I accept the play on my initials because it causes adversaries to underestimate me.

I am 66-years-old. My grayish blond hair is thin and my full beard is a bit scraggly. My face is round and often tinged with red. My nose is full, my eyes green and my cheeks bulge out to the sides trying to emulate the belly that precedes every other part of my body as I walk. People see me and do not believe that I am a private investigator. Seeing me they often think that I am on leave from my winter work as a Macy’s Santa Claus.

I like being underestimated. It makes my job as an investigator easier.

See how a fake robbery at a jewelry store led to murder and prison.

Available as a Kindle book.

Available as a paperback

Product Details

When the women first met – 20 years ago at a Santa Monica health spa – Magogassasanian appeared taken with Gogolivesky. The women moved Alvarado into an apartment, then started applying for life insurance policies on him. They jointly took out four policies, each as 50% beneficiaries in addition to the individual policies they bought from my client. Gogolivesky also took out three more policies on her own while Magogassasanian only took out a single individual policy on Earnest. The two women pocketed nearly $6,000,000 in insurance benefits on Alvarado alone and $4,000,000 in insurance benefits on Earnest. They also recovered a total of $5,000,000 on the other six old men they killed.

Available as a Kindle book.

Available as a paperback.

Arson for Terrorism and Profit

Arson for Terrorism and Profit: How an Insurance Investigator and Insurance Lawyer Defeated a Plot to use a Fire to Fund Terrorism by [Zalma, Barry]How an Insurance Investigator and Insurance Lawyer Defeated a Plot to use a Fire to Fund Terrorism (c) 2020 by Barry Zalma & ClaimSchool, Inc.

There are many excuses for the inability of the criminal justice system to effectively handle arson cases and eventually, almost universally, the prosecutor will find an excuse not to prosecute an arson case regardless of the amount of evidence produced. As a result, with regard to an arson-for-profit scheme, the time, investigative work, and litigation is left to the insurer to refuse to pay a claim based on fraud, pay the investigators and lawyers needed to prosecute a civil fraud defense to a fraudulent claim created with an arson-for-profit scheme.

The following story is based upon an attempted arson-for-profit that took up a large portion of my professional career. Although fiction, the story is based on a true crime that involved the efforts of the intended victims – an English insurer and an American insurer – the work of professional fire cause and origin investigators, private investigators, insurance claims handlers, insurance coverage lawyers and insurers who refused to pay tribute to a criminal. After five years of investigation and litigation the defendants established that the arson-for-profit scheme was designed for more than cash but was intended to obtain funds to support a terrorist organization whose purpose was to kill or maim anyone connected to the government of Germany.The names, places, professions, organizations, fire departments, police, prosecutorial agencies and of the individuals involved have been changed to protect the innocent, criminal, and professional.

Available as a Paperback

Available as a Kindle book

The problem is that each option the insurers have available have a down side and Feng is represented by a lawyer who has proved highly successful in suing insurers and collecting large compensatory and punitive damage awards. Since the claims exceed $6 million dollars, he can expect, applying the law set out by the U.S. Supreme Court in State Farm Mut. Automobile Ins. Co. v. Campbell and BMW of North America, Inc. v. Gore as much as $60 million in punitive damages. So I need to explain to the insurers that they face an exposure anywhere from their policy limits to ten times the policy limit. They need the courage of their convictions to reject this major claim.

Available as a paperback.

Available as a Kindle book.

Arson-For-Profit Fire at the Cowboy Bar & Grill

A true crime novel based on the experience of the author, Barry Zalma, who for more than 51 years has acted for insurers who were faced with arson-for-profit, one of the most dangerous insurance fraud schemes. The book explains how an insurance claims adjuster, working with a fire cause and origin expert, a forensic accountant and insurance coverage lawyer, were able to defeat an arson-for-profit scheme and obtain a judgment requiring the perpetrator to take nothing and repay the insurer all of its expenses in defeating the claim.

Available as a paperback.

Available as a Kindle book.


The Insurance Law Deskbook

9781949884296The Insurance Law Deskbook is intended to help law students, practitioners, insurance lawyers, professional claims personnel, insured persons, and anyone else involved in insurance. The book, published for the first time under Full Court Press, includes the full texts and digests of insurance-related decisions of the U.S. Supreme Court, the U.S. District Courts of Appeal, state appellate courts, and foreign courts that have molded the American insurance law, as well as vital explanatory chapters, historical context, form letters, and more.

Paperback, only $95.00 available at https://www.fastcase.com/store/fcp/insurance-law-deskbook-2/

California Insurance Law Deskbook

9781949884289

California has long led the way when it comes to insurance jurisprudence in the United States, and few know more about California insurance law than Barry Zalma.

Available at https://www.fastcase.com/store/fcp/california-insurance-law-deskbook/ a paperback for only $95.00.

Zalma on Property and Casualty Insurance

The earnings of almost every civil lawyer in the United States are funded by the insurance industry. Insurance can best be described as the mother’s milk of the law profession. The civil defense lawyer is paid by an insurer for each hour he or she works. The civil plaintiffs’ lawyer is usually paid by taking a percentage of any judgment entered in favor of the plaintiff, which judgment is usually paid by the defendant’s insurer.

In almost every situation in which a civil lawyer practices law the funds for that work come, either directly or indirectly, from insurance. Consequently, lawyers must use their wits and energies to avoid or to pursue litigation to the benefit of the client. Both sides understand that an insurer will eventually pay one or both sides in the dispute. Insurance is important to every civil dispute and even some that fall within the criminal courts.

Every lawyer retained to prosecute or defend a civil suit should begin the representation with a serious effort to find insurance coverage for the benefit of the client or the defendant the client is suing. Without that knowledge, the lawyer will find he or she is litigating with duct tape firmly self-placed across his or her mouth.

Insurance Law DeskbookZalma

Learn the insurance basics that are essential to every civil practitioner. Available at Fastcase.com bookstore.

California Insurance Law Deskbook

California has long led the way when it comes to insurance jurisprudence in the United States, and few know more about California insurance law than Barry Cal LawZalma. Available at Fastcase.com bookstore.

Insurance Bad Faith and Punitive Damages Deskbook

Understand the relationship between insurance, the tort of bad faith, and why punitive damages are awarded to punish insurers.

An annual subscription to secondary content on the Fastcase BadFaithplatform includes new editions and updates published by the author as they are rolled out, so you can rest assured that your research is up to date. Go to fastcase.com for more detail and how to use the material on-line as part of your legal or insurance research or as stand-alone e-books.

All available at fastcase.com bookstore.


Insurance Law is the most comprehensive, and yet practical, Product Detailsinsurance law authority available today. Written by nationally-renowned insurance coverage expert Barry Zalma, an insurance coverage attorney, consultant, expert witness and blogger, Insurance Law introduces the new insurance professional to the fundamental principles of insurance and provides the experienced litigator analyses of today’s leading insurance law decisions nationwide.

Insurance Law is the most comprehensive, and yet practical, insurance law authority available today.

This book is ideal for any professional who works in or frequently interacts with the insurance industry. Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense), business owners, and students will benefit greatly from this all-inclusive reference. It is also the perfect resource for educators and trainers whose role requires an understanding of insurance law.

In addition to case law, the author has provided countless citations to relevant statutory, regulatory, and judicial sources which are guaranteed to kickstart your research.

Price Reduced from $196- Send Check for $75.00 to ClaimSchool, Inc., 4441 Sepulveda Blvd., Culver City, Ca 90230 and the book will be mailed to you.

Today, mold claims are common, but they continue to grow in complexity, involving not only property damage but bodily injury as well. Mold-related lawsuits have dramatically increased over the past few years, and tProduct Detailshe numbers continue to rise. Coverage requirements—and related issues—can be complicated and confusing. This resource will remove the complexity and allow the insurer, insured, property owner or developer and their counsel to deal with mold quickly and effectively and, if possible, avoid unnecessary litigation.

Price Reduced – Send Check for $50.00 to ClaimSchool, Inc., 4441 Sepulveda Blvd., Culver City, Ca 90230 and the book will be mailed to you.

This insightful and practical two volume resource was envisioned anProduct Detailsd written by nationally renowned expert Barry Zalma, and it thoroughly explains how to identify construction defects and how to insure, investigate, prosecute, and defend cases that result from construction defect claims.

Construction Defects Coverage Guide was designed to help property owners, developers, builders, contractors, subcontractors, insurers, and lenders, as well as their risk managers and lawyers rapidly resolve construction defect claims when they arise and avoid construction litigation. If litigation becomes necessary it will help the prosecution or defense of construction defect suits effectively.

Price Reduced from $196 – Send Check for $75.00 to ClaimSchool, Inc., 4441 Sepulveda Blvd., Culver City, Ca 90230 and the book will be mailed to you.

Insurance contracts and clauses are specific in nature—but the manner in which insurance claims are pursued and resolved can be remarkably different. Mistakes in handling a claim can undermine the outcome—and ultimate value—of the claim itself.

Insurance Claims: A Product DetailsComprehensive Guide is the one resource that enables insurance professionals, producers, underwriters, attorneys, risk managers, and business owners to successfully handle insurance claims from start to finish—employing proven, practical techniques and best practices every step of the way.

Price Reduced from $196 – Send Check for $75.00 to ClaimSchool, Inc., 4441 Sepulveda Blvd., Culver City, Ca 90230 and the book will be mailed to you.


The Commercial Property Insurance Policy Deskbook is a comprehensive resource on acquiring a commercial property policy and presenting and collecting first-party property insurance claims. The book looks at the fundamentals of insurance and a wealth of topics including rules of construction of a policy of commercial property insurance, the commercial first party property insurance policy, different types of property losses, conditions and limitations,specific and blanket coverages, mortgage clauses, the need for a prompt notice of claim, the commercial property claim, adjusting the commercial property loss, the sworn statement in proof of loss, the adjustment of the commercial property loss, subrogation and salvage, and common law bad faith.

Also included are five appendixes of forms, letters, and other documents.

Available from the American Bar Association at: http://shop.americanbar.org/eBus/Default.aspx?TabID=251&productId=214624; or  orders@americanbar.org, or 800-285-2221.

Author: Barry Zalma

Sponsor(s):  Tort Trial and Insurance Practice Section, Publisher(s):   ABA Book Publishing

ISBN: 978-1-62722-676-9
Product Code: 5190506
2014, 638 pages, 7 x 10

Product DetailsThis book is written for individuals who are focused on the effort to reduce expensive and pervasive occurrences of insurance fraud. Lawyers who represent insurers, claims personnel, prosecutors and their investigators can all benefit from this exhaustive resource.

The Insurance Fraud Deskbook is a valuable resource for those who are engaged in the effort to reduce expensive and pervasive occurrences of insurance fraud. It explains the elements of the crime and the tort to claims personnel, and it provides information for lawyers who represent insurers, so they can adequately advise their clients. Prosecutors and their investigators can use this book to determine what is required to prove the crime and win their case.

The full text of decisions from courts of appeal and supreme courts across the country are provided so the reader can understand what happens after the investigation is completed and can apply that information to undertake their own thorough investigations. It allows claims personnel and their lawyers to understand what errors would cause a defeat or a not-guilty verdict.

The effort to reduce insurance fraud requires the assistance of both civil and criminal courts. The Insurance Fraud Deskbook can help the prudent fraud investigator, insurance adjuster, insurance attorney, insurance Special Investigation Unit, and insurance company management to attain the information needed to deal with state investigators and prosecutors.

Available from the American Bar Association at: http://shop.americanbar.org/eBus/Default.aspx?TabID=251&productId=214624; or  orders@americanbar.org, or 800-285-2221.

How to Determine the Proper Measure of Damage to Real and Personal Property

ISBN: 978-1-63425-295-8
Product Code: 5190524
2015, 235 pages, 7 x 10, Paperback

This book was written to provide sufficient information to those who became interested in the issue since the Georgia Supreme Court decided State Farm Mutual Automobile Insurance Co. v. Mabry274 Ga. 498, 556 S.E.2d 114 (Ga. 11/28/2001) and includes cases dealing with the use of diminution in value as a method of determining the amount of loss incurred by a plaintiff seeking indemnity for damage to real or personal property.

Because confusion has reigned across the United States concerning the proper measure of damages for property damage to property that has been repaired, Diminution In Value Damages assists the reader in answering the questions concerning the proper measure of damage in each of the fifty United States and federal United States jurisdictions

This edition has been totally rewritten and expanded, providing the most extensive and detailed coverage of the issue and a thorough explanation of how to apply diminution in value damages to losses to property.


Co-Author(s):Property Investigation Checklists: Uncovering Insurance Fraud, 12th

Property Investigation Checklists: Uncovering Insurance Fraud provides detailed guidance and practical information on the four primary areas of any investigation of suspicious claims:

• Recognizing suspicious claims

• Proper investigation procedures

• Analysis of laws concerning fraudulent personal and real property claims

• Evaluating and settling claims.

The book also examines recent developments in areas such as arson investigation procedures, bad faith, and extracontractual damages. The appendix includes the NAIC Insurance Information and Privacy Protection Model Act.


Source link