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Evidence of materiality | Zalma on insurance



Watch the full video at https://rumble.com/vobcam-proof-of-materiality.html and at https://youtu.be/dJtl3ImVjLU

Every termination requires proof that the facts which were incorrectly presented or concealed were material.

Different courts have characterized the element of materiality differently. For example, in Connecticut:

A fact is material. . . when. . . it would increase the degree or nature of the risk of the insurance so that it significantly affects its issuance or significantly affects the premium. Davis-Scofield v. Agricultural Insurance Co., 109 Conn. 673 on p. 678, 145 A. 38 on p. 40 (1920).

In Indiana:

The insureds' representations are essential to the risk if a truthful answer would cause the insurer to refuse to issue insurance or charge a higher premium. Holtzclaw v. Bankers MutualInsurance Co., 448 N.E. 2d 55 on p. 58 (Ind. App. 3d Dist., 1983).

Imperial Casualty and Indemnity Co. v. Sogomonian 198 Cal. App. 3d 169, 243 Kal. Rptr. 639 (Cal.App.Dist.2 02/04/1988).

Although not relevant to the issues presented here, in the same complaint Imperial also claimed damages from another defendant, Larklo Dersarkisian, dba Derian Insurance Agency (Derian), for alleged negligence and fraud committed by the said defendant in the preparation and submission of the defendants' application on 7 June 1982 to the Imperial. This claim was not affected by the decision to give a brief judgment against the defendants and is still awaiting trial in this action. In statements filed as a successful opposition to Imperial's simultaneous claim for summary judgment against him, Derian stated that he had prepared the application based on information provided to him by the defendants.

Our conclusion here should not result in an assumption by the insurers that the policy liability can be avoided or delayed with impunity by asserting a claim for revocation. It is a tactic associated with danger. If there is no valid ground for revocation, the threat or attempt to seek such relief may in itself constitute (1) a breach of the Good Faith and Just Settlement Union as implied in the policy (Fletcher v. Western National Life Ins Co . (1970) 10 Cal. App. 3d 376, 392, 401 [89 Cal. Rptr. 78, 47 A.L.R.3d 286]) and / or (2) performing one or more of the unfair claims settlement methods prescribed in Insurance Code section 790.03, subsection (h). (italics added)

Mr. Sogomonian was not a nice man. Among other things, he was the subject of hearings before the US Congress, in S. Hrg. 104-604, May 15, 1996, Russian Organized Crime in the United States [http://www.archive.org/stream/russianorganized00unit/russianorganized00unit_djvu.txt] where some of the testimonies included that of U.S. Had the insurance companies known about the information reported to the US Senate, they would have been more careful in their contacts with Mr. Sogomonian. The fact that the lawsuit was settled by evidence of rescission eliminated the need for evidence of criminal activity and arson.

took his hands from his weapons. In addition, after the testimony was completed, the bailiff offered to escort the author safely to the elevator.

People who lie on an insurance application will find, if the insurer discovers the lies, without insurance. Termination is an important remedy for defeating insurance fraud because people who commit fraud know what to do to deceive an insurer but do not understand insurance law. It is therefore essential that each investigation of insurance claims includes a verification of the facts presented in the application for insurance and if an erroneous presentation is discovered which was essential for the insurer's decision to either accept or reject the application for insurance.


] © 2021 – Barry Zalma

Barry Zalma, Esq., CFE, now limits his internship to the position of insurance consultant specializing in insurance coverage, insurance claims handling, insurance misconduct and insurance fraud almost equally for insurers and policyholders.

He also acts as an arbitrator. insurance-related disputes. He practiced law in California for more than 44 years as a lawyer for insurance coverage and claims management and more than 54 years in the insurance industry.

Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome.

He is available at http://www.zalma.com and zalma@zalma.com. Zalma is the first recipient of the first annual Claims Magazine / ACE Legend Award. 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 claimants to become professionals in insurance claims.

Go to training available at https://claimschool.com; articles at https://zalma.substack.com, the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr Zalma on Twitter at https://twitter.com/bzalma ; Go to Barry Zalma videos at https://www.rumble.com/zalma; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ T the last two issues of ZIFL are available at https://zalma.com/zalmas-insurance-fraud- letter -2 / podcast now available at https://podcasts.apple.com/us/podcast/zalma-on-insurance/id1509583809?uo=4


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