Whenever homeowners and business owners contact the Merlin Law Group’s Los Angeles office about selecting a new insurer, I always remind them that the doctrine of uberrimae fidei imposes a duty of utmost good faith to tell the truth when they fill out their new insurance policy application. This is especially important for potential insureds who have a claim history. If you fail to disclose material information when directly asked in the application, be prepared to swallow the insurance company’s Jagged Little Pill.
Continue Reading You Oughta Know – Insurer Fails to Create New Standard for Application Disclosures in California

We’ve all likely seen USAA’s recent commercial campaign featuring Super Bowl Champion Rob Gronkowski attempting, unsuccessfully, to obtain insurance with USAA.

Although the commercials are lighthearted and humorous, they also raise an important point about the application for insurance benefits.
Continue Reading Accuracy in the Application for Insurance is Necessary to Avoid Claims of Misrepresentation

Insurance applications are extremely important. An otherwise covered claim can be denied because of an application error. A recent case1 quoted Michigan law about misrepresentation in the application of a property insurance policy:
Continue Reading What is the Michigan Law on Misrepresentation in the Application for Property Insurance? Can a Wrong Answer About Taxes Void the Policy?

A recent Florida case1 has a lengthy discussion about cases where changing valuations by the insured are then used by clever insurance company attorneys to argue that a post-loss fraud has occurred. This is now a common practice in litigation throughout the country as policyholders, public adjusters, and contractors make differing estimates of loss and have different opinions about what the measure of the loss should be.
Continue Reading Insurance Company Attorneys Often Wrongfully Argue That a Fraud Occurs When Parties Only Have a Difference of Opinion

Memorial Day usually finds millions of Americans traveling all over our great country. It is important that over this weekend, all of us take time to remember and reflect on the greatest sacrifice many made so we can enjoy our liberties. If your property burns down under suspicious circumstances, you may also want to remember and reflect on where you were and your activities as well because the insurance company claims representatives will be curious.
Continue Reading What Were Your Activities Over Memorial Day Weekend? A Quick Case Study on Post Loss Misrepresentations, Overvaluation and Arson

Misrepresentations in an insurance policy application may provide a basis for an insurance company to deny an otherwise valid claim following a loss. In such circumstances, the insurance company argues that the insurance policy was null and void from its inception based on the misrepresentation because it would not have issued the policy or would not have issued it under the same terms if the misrepresentation had not been made.
Continue Reading Can My Insurance Company Deny My Claim After A Loss Based Upon A Misrepresentation in My Insurance Policy Application?

My Red Bank colleague, Dan Ballard, and I recently gave a presentation about Misrepresentations & Mistakes at the 2020 Fall Conference of the Professional Public Adjusters Association of New Jersey (PPAANJ). During that presentation, I discussed New York case law providing that a homeowners insurance policy may be voided if the insured willfully and fraudulently places in the proof of loss a statement of property lost which the insured did not possess, or places a false and fraudulent value upon the articles which the insured did not own.
Continue Reading Incorrect Information Within Proof of Loss Not Enough To Void Insurance Policy

(Note: This guest blog is by Kathryn Ray, a Summer Law Clerk in our Tampa office)

When sustaining property or casualty damage and after filing a claim with an insurance company, the insurance company may then request a proof of loss. A proof of loss is defined as “a policyholder’s statement of the amount of money being requested, signed to and sworn to by the policyholder with documentation to support the amount being requested.”1 In New York, if an insurance company gives the insured a written notice, after a loss, requesting a proof of loss the insured shall then have 60 days after receiving this notice to comply with the insurance company’s request.2 This compliance period to provide the insurance company with a proof of loss may also be longer than 60 days if the insurer specifies so in their written notice.3
Continue Reading Misrepresentations and Proofs of Loss in New York

Insurance applications are important. A Florida trial court recently held that an unsworn and unsigned telephonic statement made during an application for insurance does not qualify as former testimony or a business record under the Florida Rules of Evidence, thereby making it inadmissible as summary judgment evidence.1
Continue Reading Statements Made During an Application for Insurance are Important