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Policy for annulment of fraudulent claims | Zalma on insurance



In order to successfully commit arson for profit, the perpetrator needs some intelligence and some knowledge of insurance. When the perpetrator is incompetent, claims property removed from the object of the insurance before he or she is set on fire, he or she will be caught and will get something back from the crime. I K enny Thomas v. Certain Underwriters At Lloyd & # 39; s, London No. 4: 20-CV-00275 BSM, United States District Court, E.D. Arkansas, Central Division (December 8, 2021) Kenny Thomas proved to be a totally incompetent arsonist and lost every opportunity to regain everything from his attempt to take advantage of his arson.

BACKGROUND

In June 2019, a fire broke out in Kenny Thomas' home in Pine Bluff, Arkansas. After the fire, Thomas filed an insurance claim with Lloyd & # 39 ;s for the total loss of his home and for the loss of personal property, including furniture. At the time of the fire, Thomas was behind with his mortgages and the home was listed for sale.

When the Pine Bluff Fire Marshal inspected the property, he found no debris or debris indicating that furniture was destroyed in the fire. Lloyd & # 39 ;s also hired the Midwest Fire Consulting Group ("Midwest Fire") to investigate, and Midwest Fire concluded that there was no evidence that furniture or personal items were destroyed in the fire. Midwest Fire further concluded that the fire was flammable using flammable liquid to improve the combustion process, and that the source of ignition was an open flame held by a human hand.

In July 2019, Thomas prepared evidence of the loss. statement that included a sofa, loveseat and ottoman that he reportedly bought from Ashley Furniture. Thomas later testified in an undercover investigation that the evidence of the loss he worked out was correct and that the furniture he reported lost was his property and had been moved into the home before the fire.

Lloyd & # 39 ;s was faced with blatantly false swearing and attempted fraud, denying coverage for Thomas' claim. Lloyd & # 39 ;s, denied the allegation after establishing that he intentionally caused the fire and violated the insurance's terms of concealment or fraud, which invalidated the insurance. Following this denial, Thomas Lloyd & # 39 ;s sued for breach of contract and refusal in bad faith of insurance benefits.

The Arkansas Insurance Department ("AID") then initiated a criminal investigation into Thomas' insurance claims. AID discovered that almost nine months after the fire, Thomas' girlfriend filed a claim under a furniture protection plan and received a replacement pillow for one of the sofas from Ashley Furniture that Thomas claimed had been destroyed. The replacement pillow was delivered to a home where Thomas and his girlfriend had both lived. AID obtained a search warrant for Thomas and his girlfriend's current home and found that the Ashley Furniture items were in the home and had not been destroyed in the fire that Thomas had represented during the investigation of the claim. Lloyd & # 39 ;s concluded that the evidence obtained by AID was conclusive evidence of fraud.

Lloyd & # 39 ;s sought a summary judgment, claiming that Thomas' false representations invalidated his homeowners' insurance policy and that Thomas' claim coverage was properly denied. Thomas did not respond to Lloyd's motion.

DISCUSSION

Summary assessment is appropriate because Lloyd & # 39 ;s correctly denied Thomas & # 39; homeowners' insurance claims under the insurance's concealment or fraud terms. The relevant provision of Thomas' insurance with Lloyd & # 39 ;s states: & # 39; insured the property, insurance coverage, or the loss. "

There is no real dispute that Thomas incorrectly represented that he had lost some furniture in the fire. In addition, by not responding to Lloyd & # 39 ;s request for a summary judgment or submitting its own statement of facts, Thomas & # 39 ;s misrepresentations are deemed to have been acknowledged. the right to a summary judgment on Thomas' claim for refusal in bad faith of insurance benefits Homas can recover from bad faith only if Lloyd & # 39 ;s has committed to dishonest, malicious, or oppressive misconduct in its attempt to avoid liability under the policy, without good faith reason to do so. This is a difficult standard to meet. Nothing in the document indicates that Lloyd's actions were dishonest, malicious or oppressive. On the contrary, Lloyd's denial of insurance benefits was consistent with the now overwhelming evidence that Thomas annulled the insurance by misrepresenting his loss. The refusal to pay a claim alone does not constitute the first party of bad faith when there is a valid controversy regarding liability for the insurance.

CONCLUSION

In summary, the verdict was announced because Lloyd & # 39 ;s correctly denied Thomas & # 39; homeowners' insurance claim under the terms of the insurance for concealment or fraud.

Thomas did not have the skill, intelligence or ability to cause a profit or fire. a fraudulent insurance claim. His inadequacy enabled Lloyd & # 39 ;s and AID to determine that he was attempting fraud. Although the fire was covered, the claim for undamaged content invalidated the entire agreement and he lost his entire claim for an Ashley furniture sofa. He should be arrested, convicted and convicted for the large-scale violent crime of arson and the crime of insurance fraud. Of course, his mortgagee can have a claim.


© 2021 – Barry Zalma

Barry Zalma, Esq., CFE, now limits his practice to being an insurance consultant specializing in insurance coverage, handling insurance claims, bad faith insurance and near-term insurance fraud. for insurers and policyholders.

He also acts as an arbitrator or media

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 claims staff 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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