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The effect of the insured's breach of a material condition



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A video explaining precedents and subsequent terms

See the full video at https://rumble.com/vpqnfu-a-video-explaining-conditions-precedent-and-subsequent.html?mref= 6zof & mrefc = 2 and at https://youtu.be/Gl8gNfb8CfQ

As early as 1897, the Supreme Court of Pennsylvania, in Early v. Hummelstown Mut. Fire Ins. Co, 178 Pa 631, 36 A. 195 (1897) considered that there is no doubt that the plaintiff had forfeited all right to reimbursement of his insurance at the time of the fire by breach of the material conditions of the insurance.

A provision prohibiting or restricting supplementary insurance is intended as a condition for the company to assume liability; and the law is well established that, in the event of a breach of such a condition, there can be no recovery on the contract in which it is included. [ Hiatt v. American Ins. Co., 1

09 SE2d 185, 250 NC 553 (NC 1959)]

Whether a precedent or a subsequent condition, the courts of Missouri have, in a number of judgments, held unanimously that a provision limiting simultaneous insurance is a guarantee which according to law is assumed to be material to the risk and that any material breach of such guarantee would ipso facto involve a forfeiture. [ Harwood v. National Union Fire Ins. Co., 156 S.W. 475, 170 Mon. App. 298 (Mo. App. 1913)]

According to Louisiana law, an insured's compliance with the provisions of an insurance policy is a condition for recovery. Therefore, an insured's failure to cooperate can be considered a material breach of the insurance and a defense against an insured's lawsuit against the insurance. More specifically, an insured's failure to submit to an oath examination or its refusal to present requested documentation may violate the insurance's co – operation clause. Failure to cooperate precludes recovery when the insured participates in a "protracted, intentional and manifestly bad faith refusal" to comply with a co-operation clause. [ LeBlanc v. Davis 254 La. 439, 445-446 (1969); Lee v. United Fire & Cas. Co 607 So.2d 685, 688 (La. App. 4th Cir. 1992); Kerr v. State Farm Fire & Cas. Co 511 Fed. App’x 306, 307 (5th ed. 2013); Hamilton v. State Farm Fire & Cas. Ins. Co 477 Fed. App’x at 165; Lee v. United Fire & Cas. Co. [ Unitrin Advantage Ins. Co. v Dowd 143 NYS3d 543 [1st Dept 2021] Failure to appear for an EUO requested by the insurer in time is a breach of a condition that precedes coverage and invalidates the insurance ab initio . [ Unitrin Advantage Ins. Co., 82 AD3d at 560; Alsaad Med., P.C. v. State Farm Mut. Car. Ins. Co., 2021 NY Slip Op 50532 (U) (NY Civ. Ct. 2021)]

I Motiva Enterprises, LLC v. St. Paul Fire and Marine Insurance Co

© 2021 - Barry Zalma

Barry Zalma, Esq., CFE, now limits his internship to a job as an insurance consultant specializing in insurance coverage, insurance claims management, insurance fraud and 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.

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