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It's fatal to your claim to lie to your insurer



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Lie to an insurer and lose everything

Watch the full video at https://rumble.com/vpfk7c-it-is-fatal-to-your-claim-to-lie-to- your -insurer.html and at https://youtu.be/_R3hItia8E4

False swearing is a special category of deception or concealment because it is done under oath. In criminal law, false swearing is called perjury.

If there were any false swearing regarding the property that was the subject of the insurance, it was incorrect. if there was false swearing regarding the meat and corn, it violated the policy of these articles. In fact, the instruction told the jury that if they believed that there were false swear words regarding the meat and corn, the result would be that the insurance would be damaged and that the plaintiff would not have the right to get back the insurance benefits. [ Williams v. Va. State Ins. Co, 55 S.E. 680, 1

06 Va. 259 (1906)]

In order for a "false swear word" to invalidate an insurance policy, the false swear words must have been intentional, made with respect to a material issue and made with the intent to mislead the insurer. [ Gould v. M.F.A. Mutual Insurance Company 331 S.W.2d 663, 669 (Mo.App.1960); Joiner v. Auto-Owners Mut. Ins. Co ., 891 SW2d 479 (Mo. App. 1994)]

If an insurance policy stipulates that an insured's concealing, misleading presentation, fraud or false swearing annuls the insurance, the insured must actually have intended to defraud the insurance . [ West v. Farm Bureau Mutual Insurance Co. of Michigan 402 Mich. 67, 259 NW2d 556 (1977)]

Under Michigan law, fraud must be proved with clear and convincing evidence, [ Disner v. Westinghouse Electric Corp. 726 F.2d 1106, 1109-11 (6th Cir . 1984)] even when it was taken up as an affirmative defense. Under Michigan law, therefore, the insured's intent to misrepresent a loss certificate is an essential fact because it is a false oath. [ Madkins v. State Farm Fire & Cas . (E.D. Mich., 2019)]

Mississippi has a different view when there is more than one part of an insurance policy. An insurance that insures different items and determines the amount of insurance to be paid for each can be separated, even if the premium is determined in its entirety; and that since the policy is invalid for one point, this fact does not mean that it cannot be enforced for the others. [ Darden v. Liverpool & London & Globe Ins. Co ., 109 Miss 501, 68 So. 485; Scottish Union & National Ins. Co. v. Warren Gee Lumber Co 118 Miss. 740, 80 So. 9, 12 and National Union Fire Ins. Co. v. Provine, 148 Miss. 659, 114 So. 730.]

On the other hand, in Michigan, even when viewed in a light that is most favorable to the plaintiff, the evidence presented established that the plaintiff's claims of faultless benefits were based on fraud and false swearing. Reasonable thoughts could not distinguish between the plaintiff engaging in fraud for the purpose of recovering benefits without error. Because she did so, the Farm Bureau had the contractual right to annul the insurance and deny her faultless benefits. [ Parker v. Farm Bureau Gen. Ins. Co . (Mich. App., 2019)]

In accordance with Oklahoma law, an insurer who claims that the insured has violated a fraud and false swearing in an insurance policy must prove it with "a reasonable consideration of the evidence" and not "clear and clear convincing evidence ”required in other states. [ Transp. Ins. Co. v. Hamilton 316 F.2d 294, 296 (10th ed. 1963); Century Sur. Co v. Shayona Inv., LLC 840 F.3d 1175 (10th Cir., 2016)]

A regulation on concealment and fraud in an insurance policy clarifies that the general rule in insurance law that requires good faith and fair handling applies to fraudulent statements and false swear words of an insured after a loss. [ Domagalski v Springfield Fire & Mar. Ins. Co. 218 App Div 187, 189 [1926]) This provision is violated if an insured leaves a fraudulent evidence of loss as a basis for recovery under the insurance. [ Saks & Co. v Continental Ins. Co 23 NY2d 161, 165 [1968]; Kantor Silk Mills, Inc. v Century Ins. Co., Ltd., 253 NY 584 [1930]) and Gray v. Tri-State Consumer Ins. Co ., 2015 NY Slip Op 32522 (U) (NY Sup. Ct., 2015)]

In Mutual of Enumclaw v. Cox 757 49), (1d 89), ( 91d) Washington's Supreme Court was asked to interpret a policy of homeowners stating that the entire policy would be invalid if "there has been fraud or perjury." Although the insured's fraud only concerned his unplanned personal property, the court held that the entire insurance was invalid and that the insured was not entitled to any recovery. This seems to be the position of the majority that one cannot commit a little fraud as little as one can be a little dead.

An insured's idea of ​​distorting essential facts for the insurer is irrelevant in determining whether a fraud and secrecy provision provides a defense against the insured's claims. In the following case, the insured presented a fraudulent claim for damages for damage caused by her son intentionally. The insured felt compelled to lie because she had been threatened with physical harm by her son, who had previously been convicted of violent behavior, and who caused the injury. The California Court of Appeal stated:

First, the plaintiff admits that she knew she was lying to the defendant and did so with the intent that the defendant would not find out the actual facts. Second, under Claflin, the intent to deceive the insurer is necessarily implied when the misrepresentation is material and the insured knowingly does so with knowledge of its falsity. Thus, the plaintiff's intention to mislead as a matter of law Cummings v. Farmers Ins. Exchange, 202 Cal. App. 3d 1407, 249 Kal. Rptr. 568 (Cal. App. 2 Dist. 1988). (My italics.)

This conclusion is somehow avoided by the plaintiff's assertion that the motive for the false statements was her very reasonable fear of her son. As stated by the United States Supreme Court in Claflin an insured's idea of ​​misrepresenting essential facts to the insurer is irrelevant. In connection with the case Cummings the plaintiff's motive for fear of her son's violence was irrelevant to the question of whether she intended to deceive the insurer. Cummings, supra .

If Mrs Cummings' son was her husband or an insured by the insurance company, she may have recovered half of the loss if she had not lied about the insured's conduct causing the insurance damage. It is not fraud to negligently damage property and acknowledge your negligence. It is also not fraud if an insured person in a madness attack destroys the property and with the help of drugs comes back to the checkpoint and admits what has been done while he is incompetent. It is the lie that causes the insured to run into problems with the SIU investigators and the courts.

In Texas and Oklahoma, false swear words are explained as follows: the insured's right to recover disappears. " [ Summit Machine Tool Manufacturing Corp. v. Great Northern Insurance Co . 997 SW2d 840 (Tex. App. Dist. 3, 1999)].

The Mississippi declared the Supremeiss Court. the "false swearing" defense that "[i] it would be unfair to allow a plaintiff to misrepresent facts that could lead to a valid defense and then allow him to escape the consequences of falsehood just because he had succeeded so well that the company could not establish the defense ”, Edmiston v. Schellenger 343 So. 2d 465, 467 (Miss. 1977), cited with approval in Duke v. Hartford Fire Insurance Co 617 F.2d 509, 510 (8 9th [1904] Cir. Per curiam) [Applies to Arkansas law.]

In North Carolina, the Court of Appeals recognized that:

It is a fundamental principle of insurance law that the insurer can evade its obligation under the insurance contract by showing that the insured made material and false petitions in his application. . Pittman v. First Protection Life Insurance Co ., 72 N.C. App. 428, 433, 325 S.E. 2d 287, 291 (1985).

Incorrect information about an insurance application is essential if the knowledge or ignorance of it would naturally affect the insurer's judgment regarding entering into the contract and accepting the risk. [ Bryant v. Nationwide Mut. Fire Ins. Co 67 N.C. App. 616, 621, 313 SE2d 803, 807 (1984), Revd On Other Grounds, 313 NC 362, 329 SE2d 333 (1985).]

In order to annul the policy in accordance with GS-158, -4 the defendant must show that the insured made statements that were:

  • false;
  • knowingly and knowingly done; and
  • [ Bryant v. Nationwide Mut. Fire Ins. Co 313 N.C. 362, 370, 329 S.E. 2d 333, 338 (1985). Bell v. Nationwide Insurance Co. No. COA00-1464 (N.C. App., 11/06/2001).]

False swearing is a crime in all states if it involves perjury. If it does not mean perjury, it is still a defense against a false statement. In order to establish that an insured person intended to mislead an insurer under Missouri law, the insurer must show that the insured:

  • knew that the representation was false or did not know whether the representation was true or false, and
  • intended to the insurer trust the representation.

I Young v Allstate Ins. Co 759 F.3d 836, 841 (8th circuit 2014) the eighth circuit, concluded that during an investigation under oath, Youngs acknowledged that the initial inventory listed many items that were not damaged or destroyed in the fire. They gave different explanations for the deviations. The Youngs both denied that they had deliberately exaggerated the claim to the Allstate. The district court granted summary judgment to Allstate because the Youngs, by signing the first inventory, were deemed to have knowledge of its contents, and that "no reasonable member of the jury could conclude that [the Youngs] did not materially misrepresent their property claim."

An insurer may assert false swear words as an affirmative defense against an action brought by an insured person. Real trust is not necessary.

In Parasco v Pacific Indemnity 920 F. Supp. 647 (DD Pa., 1996), false swear words were important where the insurer suspected even though the insurer could not prove arson from the insured, there was a legitimate question as to whether the fire was a fire. dangerous in nature. The insurer also had clear evidence of inaccuracies that the insured under oath had asserted, including their active attempts to sell the property at the time of the fire. The court held that the materiality of false information should be established at the time of the investigation. The court further held that the insurer's investigation into the insured's possible motive to commit arson was entirely reasonable and prudent, and investigations into the insured's financial position were therefore essential to the question of the motive.

of the insured, all material untruth is sufficient to establish the defense of false swear words. The same applies to any differences between the facts cited during the examination of the oath or stated in the evidence of the damage, and the facts developed from an examination of the insured's books and registers or an insurer's investigation.

United States Supreme Court. stated the rule as follows:

A false answer to any matter of fact relevant to the investigation, knowingly and intentionally, with intent to deceive the insurer, would be fraudulent. If it achieved its result, it would be a scam. if it failed, it would be an attempted fraud. No one can be allowed to say, with regard to his own statements on a material question, that he did not expect to be believed; their materiality, in the eyes of the law, consists in their tendency to influence the behavior of the party who has an interest in them and to whom they are directed. [ Claflin v. Commonwealth Insurance Co ., 110 U.S. Pat. 81, 3 S. Ct. 507, 28 l. Ed. 76 (1884).]

ZALMA OPINION

Insurance is an activity of the utmost good faith. This means that neither party to the insurance contract may do anything to deprive the other contract of benefits. Therefore, when an insured lies to the insurer to convince it to insure, or to convince it to pay more than it owes, he or she violates the union of good faith and fair handling and, according to the terms of the insurance contract, terminates the coverage. It's not nice to lie to your insurer. It's fatal to any claim to lie to your insurer.


© 2021 – Barry Zalma

Barry Zalma, Esq., CFE, now limits his practice to being an insurance consultant specializing in insurance coverage, insurance claims and insurance claims, insurance. insurance fraud almost equally for insurers and policyholders.

He also acts as an arbitrator or mediator for 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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