Law360 published an excellent article, The Insurance Landscape For Phishing Claims Is Shifting,1 written by Jason Rubinstein and Jasmine Chalashtori. Their summary about the importance of coverage for these computer fraud claims and the need for brokers to discuss these risks with their business clients was highlighted at the end of their article:
Continue Reading Computer Fraud, Phishing, and Cyber Insurance Claims Pose Significant Risks and Coverage Issues

Drew Houghton heads up Merlin Law Group operations in our Oklahoma City office. I was speaking with him just before our holiday party about the American Policyholder Association combating fraudulent engineering reports harming policyholders as noted in, American Policyholder Association Makes Resonating Comments About Insurance Fraud Against Policyholders. Drew then told me about a recently filed Oklahoma class action where engineers were accused of sham reports to help prevent earthquake claims payments.
Continue Reading Engineers Accused of Sham Reports in Class Action

Douglas Quinn is the President of the American Policyholder Association (APA.). He was in Orlando last Saturday afternoon. The meeting was somewhat impromptu and had a number of leaders from the National Association of Public Insurance Adjusters.
Continue Reading American Policyholder Association Makes Resonating Comments About Insurance Fraud Against Policyholders

On October 2, 2019, the U.S. District Court for the Middle District of Florida ruled that a dispute between an insurance company and its policyholder should proceed to appraisal despite insurance company’s allegations that it had discovered what it called evidence of fraud.
Continue Reading An Insurer’s Potential Fraud Claim Against Insured Was “No Reason to Stop or Stay Appraisal,” Court Rules

Following a devastating loss to one’s home, as is the case throughout California due to recent fires and mudslides, the process of contacting your insurer to begin the rebuilding or repair can be complicated and daunting. Many are quick to begin the rebuilding and repairs immediately or as soon as possible. However, there are requirements in working with your insurer to properly rebuild or repair. If an insured fails to follow appropriate protocols, the insurer can not only deny coverage, but do so on the basis of fraud.
Continue Reading Don’t Expose Yourself to Fraud Allegations by the Insurer

Fraud is generally defined as an act done with the intent to deceive or misrepresent others in order to attain or secure some unlawful gain or deprive a victim of a legal right. Different courts, states, and bodies of law throughout our country have their own unique causes of action based in fraud, or where fraud is the primary allegation.
Continue Reading Insurance Fraud – It’s a Widespread Industry Problem

When insurers investigate insurance claims and suspect that something about the claim is not quite right, they often assign special investigation units evaluate whether the claim lacks merit or is otherwise fraudulent. In Young v. Progressive Casualty Insurance Company,1 a federal district court in California recently upheld an insurer’s denial of its insured’s claim for the theft of his motor home based on the policy’s fraud and misrepresentation provisions. The court’s decision was based primarily on the cell phone records of the insured’s son.
Continue Reading Cell Phone Records Support Insurer’s Denial Based on Fraud

In unpublished decision, the Ninth Circuit Court of Appeals recently denied an accounting firm’s appeal relating to a claim for coverage triggered by an email scam that caused the firm to mistakenly send wire transfers of client funds to fraudsters.
Continue Reading Is an Email Scam Causing a Business to Lose Clients’ Money Covered Under a First-Party Commercial Policy?