Consultation & Expert Witness Service
For Insurers
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The tort of Bad Faith
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Bad Faith Avoidance
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Insurance Claims Handling
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Insurance Bad Faith
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Compliance with Fair Claims
Settlement Practices Regulations
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Insurance Policy Wording and
Interpretation
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Insurance Fraud Investigation and Litigation
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Insurance Coverage
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Presentation of Insurance Claims
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Defense of Insurance Claims
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Insurance Education & Training
Experts
& Consultants For Any Insurance Dispute
Zalma Insurance Consultants
(ZIC) brings Barry Zalma's more than
42 years of practical claims experience to any insurance dispute, problem or lawsuit. ZIC will help you resolve every insurance problem faced by you or your clients. The experience and skill of ZIC consultants and expert witnesses can make the difference before a jury or other trier of fact. ZIC will consult with you on any one or more of the following issues that are important to those in the business of insurance and their counsel:
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The Tort
of Bad Faith --
A ZIC
consultant or expert will assist a plaintiff in its need
to prove that the actions of an insurer breached the
covenant of good faith and fair dealing.
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Bad Faith Avoidance --
Use of an expert from ZIC will help an insurer establish that the claim was denied as a result of a good faith genuine dispute
and avoid charges of bad faith conduct.
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Coverage Problems
-- ZIC will give you and your clients advice and counsel concerning the interpretation of insurance
policy wording, recommend changes in policy wording, and offer solutions to disputes between insureds and their insurers.
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Claims Handling
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As a former claims person, and as an insurance claims educator and author Mr. Zalma and ZIC will consult with you or your clients concerning every aspect of the insurance claims process.
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Good Faith --
ZIC will consult with
insurers and their counsel to assure that the insurer can prove that
it treated the insured fairly and in good faith.
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Claims
Auditing --
ZIC will
ascertain that an insurer is fulfilling its obligation
to meet the requirements of the Fair Claims Settlement Practices statutes
and Regulations in your jurisdiction.
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ZIC and
Genuine Dispute --
ZIC
will consult with
insurers and their counsel to help establish that disputes between the insured and the insurer is genuine, reasonable
and in good faith.
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Insurance Fraud & SIU Investigations
--- As an internationally recognized expert and Certified Fraud Examiner Mr. Zalma, and ZIC
will consult with insurers and their counsel when faced
with a potential insurance fraud or individuals or corporations who believe they have been wrongfully accused of insurance fraud.
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Training and Education ---
ZIC provides
training for insurance claims, insurance brokerage,
insurance counsel and underwriting personnel training about any insurance,
insurance claims handling or insurance fraud subject.
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Mediation or Arbitration --
Mr. Zalma and Zalma Insurance Consultants
also acts as mediators or arbitrators for any dispute involving
insurance or insurance coverages or insurance claims. Using Zalma Insurance Consultants
to mediate or arbitrate an insurance dispute can save an insurer
thousands of dollars in unnecessary investigative and legal expenses.
How
to Avoid Charges of Bad Faith
Almost every lawsuit filed
against an insurance company, especially when a claim is denied, alleges that the insurer acted in bad faith. In the first party context, bad faith claims typically allege that the insurer did not have a reasonable basis to deny coverage, and that the insurer engaged in unfair or deceptive conduct in the process of handling the claim and reaching its conclusions regarding coverage. In the third party context, there is typically an allegation that the insurer failed to timely settle a claim in which liability had become reasonably clear. Insurers, with unfounded courage, deny claims based on the recommendations of a claims handler whose experience may be, and usually is, limited.
The Use of an Insurance Expert
When involved in
litigation concerning an insurance claim an expert qualified to testify concerning the custom and practice of insurers
is necessary to proving the claim of the policyholder or the
defense of the insurer
concerning:
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Claim handling
practices.
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Minimum Claims Investigation
standards.
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Insurance
policy interpretation.
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Insurance
fraud investigation.
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Insurance
policy interpretation.
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Compliance with
Fair Claims Settlement Practices Statutes.
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Compliance with
Fair Claims Settlement Practices Regulations.
In California, and other states, an expert
must have some first hand experience in insurance and insurance
claims handling to qualify to present testimony. Once qualified
it is essential that the expert
is able to credibly explain to a trier of fact,
in easy to understand language, to the party seeking to prove bad faith or a
defense to bad faith. A
qualified insurance claims handling expert can explain why or why not the insurer
reasonably, prudently and in good faith should reject or accept an insured's claim. The
testimony of the expert can defuse, if not eliminate, the plaintiff insured's allegations of bad faith.
A qualified expert can show that an insurer failed to fulfill
the custom and practice of insurers in the jurisdiction.
Many legal decisions definitively hold that an insurer's reliance on an expert in making a coverage determination or deciding a third party claim, will defeat a bad faith claim. Insurers who take advantage of the “genuine dispute” doctrine or “fairly debatable” doctrine to protect itself from charges of bad faith will save countless indemnity and defense dollars.
"An insurer can successfully oppose bad faith claims by demonstrating it relied upon the expert(s) it retained during the course of the claim investigation to deny coverage." ["Experts in Bad Faith Litigation" by Anthony R. Zelle and John W. Steinmetz, "For The Defense" May 2003.]
When an insurer is faced with a complex, difficult or fraudulent claim that it believes should be denied, the insurer should provide a complete copy of the file materials, to a ZIC claims handling
expert that support what that the insurer believes is a defense as well and those that support the claim of the insured.
If retained before the claim is denied the expert should be asked for his or her advice on how to resolve the claim. The expert should not be told the insurer’s position. The insurer should
advise the expert only that the insurer desires his or her expert opinion with regard to the resolution of the claim.
Case law makes it clear that obtaining the advice of an independent expert and consultant will make it possible to defeat a bad faith claim. Every insurer should understand that expert witnesses and consultants can significantly strengthen an insurer's defenses against claims of bad faith.
Failure of an insurer to consult with an expert can be used
by an expert for the policyholder to establish that the insurer
acted in bad faith.
Indispensable Advice
As a claims person and claims attorney for more than
42 years, Barry Zalma has represented insurers, advised insurers on claims handling, interpreted coverages, and testified as an insurance coverage, insurance fraud, insurance bad faith and insurance claims handling expert. Zalma has written insurance policies for insurers and is the author of books used daily by working claims professionals.
With ZIC as your consultant you get the expert advice and counsel many insurers have found indispensable. Consultation from
ZIC can save you and your counsel or client hundreds of hours of investigative and legal work.
Take advantage of Mr. Zalma's more than
42 years of claims experience. Allow ZIC's experience to find a resolution to your insurance dispute that is fair, intelligent, and beneficial to your client. Consultation from Mr. Zalma can save you or your client thousands of dollars in the prosecution or defense of an insurance dispute.
Instant Response
Counsel and clients, in a shortsighted effort to save expenses, often wait until the last moment to retain an expert or consultant. Expert consultants like Zalma Insurance Consultants can save an insurer,
insured, or the defense or plaintiff's attorney considerable time and expense if retained early. Because Mr. Zalma declines all litigation assignments
as a lawyer and keeps his caseload low, he can completely control his calendar and can respond to your request for advice and counsel promptly. Usually within no more than five working days, regardless of the total volume of the file materials, he will be ready to consult with you or testify on your client's behalf. If he cannot personally deal with your claim, Mr. Zalma will refer you to one of his experienced Zalma Insurance Consultants colleagues.
Mr. Zalma recommends that counsel retain the services of Zalma Insurance Consultants early and avoid wasting time and money pursuing a suit or defense that can be circumvented with his assistance. Zalma Insurance Consultants will promptly review file materials and advise you about the viability of your defense. He can also help you narrow the scope of discovery. No other insurance consultant or expert witness can offer such prompt, credible, and authoritative advice on insurance, insurance coverage, insurance fraud or insurance claims handling questions.
Fees
ZIC provides the services of Mr. Zalma as
an expert or consultant at the rate of only $450 per hour. He
requires a retainer of $6,750 that is applied to the final
invoice. The only expenses charged are those actually incurred
for travel and meals outside Culver City, California at the
exact amount paid by ZIC.
For details and a complete copy of his C.V. direct your browser to
http://www.zalma.com or E-Mail Mr. Zalma at
zalma@zalma.com or call Mr. Zalma at 310-390-4455.
Member: Forensic Expert Witness Association
FORENSIC EXPERT WITNESS
ASSOCIATION
10820 Beverly Blvd. A5
PMB 310
Whittier, CA 90601
Phone: 562
695 4600
Fax: 714 459
7198
