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April 05, 2022
A Lie About Where a Car is Garaged May Save Premium But Defeated UM Claim

Deemer Statute Does Not Provide Coverage Not Purchased

Read the full article at https://www.linkedin.com/pulse/lie-where-car-garaged-may-save-premium-defeated-um-zalma-esq-cfe and at https://zalma.com/blog plus more than 4150 posts.

Posted on April 5, 2022 by Barry Zalma

Deemer statutes, like the one enacted in New Jersey, an automobile insurance company that sells insurance both in New Jersey and in other jurisdictions is deemed to have provided the minimum PIP coverage required by New Jersey law. In Juan Guiterrez-Ganan v. Allstate Insurance Company, No. A-0646-20, Superior Court of New Jersey, Appellate Division (April 1, 2022) Juan argued that the Deemer Statute compelled Allstate to provide uninsured motorist coverage.

Juan Guiterrez-Ganan was injured in an automobile accident when his car was struck by a car driven by an underinsured motorist. Plaintiff sued his insurance company, defendant Allstate Insurance Company (defendant or Allstate), seeking to obtain underinsured motorist benefits for his injuries and losses.

The trial court granted summary judgment to Allstate and dismissed his claims.
FACTS

On April 29, 2016, plaintiff’s car was rear-ended while he was operating his vehicle near an intersection in Atlantic City. The driver of the other car was intoxicated and underinsured. As a result of the accident, plaintiff suffered personal injuries.

However, several years before 2016, plaintiff had lived in Georgia. While in Georgia, he purchased a 2010 Audi Q5, registered the car in Georgia, and obtained insurance coverage in Georgia from Allstate. In 2016 and for at least two years before, plaintiff lived and garaged his car in New Jersey.

Nevertheless, in 2016, plaintiff continued to register his car in Georgia and continued to purchase a Georgia-issued automobile insurance policy from Allstate. In his renewal application submitted in December 2015, for insurance coverage from January 2016 to July 2016, plaintiff listed his address at a street in “Savannah, Georgia.” At that time, plaintiff had a New Jersey driver’s license listing his address in “Galloway, New Jersey.” Plaintiff’s 2016 policy from Allstate did not include automobile medical payments or personal injury protection (PIP).

Plaintiff acknowledged that at the time of the accident in April 2016, he was a resident of New Jersey and had maintained and garaged his car in New Jersey for at least a year and a half before the accident.

Following the accident, Allstate paid $15,015.48 for medical expenses incurred by plaintiff, but refused to pay additional monies. In February 2019, plaintiff sued Allstate seeking underinsured motorist benefits. The trial court explained the reasons for its decision on the record but, after plaintiff appealed, the court amplified its reasons in a written opinion.

The trial court found that plaintiff’s Georgia insurance policy did not contain medical expense coverage required under New Jersey law. The trial court, therefore, held that plaintiff’s claims against Allstate were barred under N.J.S.A. 39:6A-4.5(a). In that decision, the trial court rejected plaintiff’s argument that N.J.S.A. 17:28-1.4, the “Deemer Statute,” effectively meant he had maintained the minimum coverage required under New Jersey law.
ANALYSIS

The appeal involved the interpretation of N.J.S.A. 39:6A-4.5 as applied to the undisputed material facts.

Every owner of an automobile principally garaged in New Jersey must maintain minimum liability insurance coverage, including no-fault PIP coverage of $15, 000 per person. Every standard automobile liability insurance policy shall contain personal injury protection benefits. To determine whether an automobile is principally garaged in New Jersey, the key consideration is where the vehicle is primarily or chiefly kept or kept most of the time. Moreover, any driver moving to New Jersey must obtain a New Jersey driver’s license and register his or her car within sixty days of becoming a resident.

The statutory provision advances a policy of cost containment by ensuring that an injured, uninsured driver does not draw on the pool of accident-victim insurance funds to which he or she did not contribute. The statute gives the uninsured driver a very powerful incentive to comply with the compulsory insurance laws: obtain automobile liability insurance coverage or lose the right to maintain a suit for both economic and non-economic injuries.

Under New Jersey law, plaintiff was required but failed to maintain medical expense benefits coverage. Indeed, that coverage was available to him in his Georgia policy, but he elected not to pay for it. Applying the plain language of N.J.S.A. 39:6A-4.5(a), plaintiff is barred from seeking recovery of economic or non-economic losses.

Plaintiff argued that the bar of N.J.S.A. 39:6A-4.5(a) does not apply to him because he was not operating an uninsured automobile at the time of the accident. Under the Deemer Statute, an automobile insurance company that sells insurance both in New Jersey and in other jurisdictions is deemed to have provided the minimum PIP coverage required by New Jersey law.

The statute’s general purpose is to ensure that New Jersey residents injured as a result of an accident with an out-of-state vehicle will have recourse to policies of insurance that are at least as broad as the presumptive minimal limits of a New Jersey insurance policy. The Deemer Statute requires insurers authorized to transact automobile insurance business in New Jersey to provide coverage to out-of-state residents consistent with New Jersey law whenever the automobile or motor vehicle insured under the policy is used or operated in this State.

Plaintiff argued that, by virtue of this Deemer Statute, his policy included PIP benefits; therefore, he was not uninsured. Allstate gave plaintiff the benefit of the Deemer Statute and paid his medical expenses up to $15, 000. Even if the Deemer Statute did apply, plaintiff’s suit is still barred by N.J.S.A. 39:6A-4.5(a) because he failed to maintain PIP benefits as required by New Jersey law.

The appellate court interpreted the phrase “while operating an uninsured automobile” to mean while operating an automobile that did not have the required PIP coverage. Plaintiff was barred from suing Allstate for underinsured or uninsured benefits seeking economic and non-economic losses stemming from the April 2016 automobile accident.
ZALMA OPINION

The action brought by the plaintiff was an insult to an insurer that paid his medical bills even though he had obtained the policy under false circumstance by claiming to reside in Georgia and that his car was garaged in Georgia. Rather than pay anything Allstate should have considered rescinding the policy because it was obtained by a knowing and material fraud. The court, although it reached an obviously correct decision, should have reported the plaintiff to the New Jersey Insurance Department Fraud Division since the policy he obtained from Allstate was based on a material false statement of fact.

(c) 2022 Barry Zalma & ClaimSchool, Inc.

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business. He is available at

http://www.zalma.com

and [email protected].

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Write to Mr. Zalma at [email protected]; http://www.zalma.com; http://zalma.com/blog; daily articles are published at https://zalma.substack.com.

Go to 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 Rumble.com at https://rumble.com/c/c-262921; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/

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February 21, 2025
No Coverage for Criminal Acts

Concealing a Weapon Used in a Murder is an Intentional & Criminal Act

Post 5002

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In Howard I. Rosenberg; Kimberly L. Rosenberg v. Chubb Indemnity Insurance Company Howard I. Rosenberg; Kimberly L. Rosenberg; Kimberly L. Rosenberg; Howard I. Rosenberg v. Hudson Insurance Company, No. 22-3275, United States Court of Appeals, Third Circuit (February 11, 2025) the Third Circuit resolved whether the insurers owed a defense for murder and acts performed to hide the fact of a murder and the murder weapon.

FACTUAL BACKGROUND

Adam Rosenberg and Christian Moore-Rouse befriended one another while they were students at the Community College of Allegheny County. On December 21, 2019, however, while at his parents’ house, Adam shot twenty-two-year-old Christian in the back of the head with a nine-millimeter Ruger SR9C handgun. Adam then dragged...

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February 20, 2025
Electronic Notice of Renewal Sufficient

Renewal Notices Sent Electronically Are Legal, Approved by the State and Effective
Post 5000

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Washington state law allows insurers to deliver insurance notices and documents electronically if the party has affirmatively consented to that method of delivery and has not withdrawn the consent. The Plaintiffs argued that the terms and conditions statement was not “conspicuous” because it was hidden behind a hyperlink included in a single line of small text. The court found that the statement was sufficiently conspicuous as it was bolded and set off from the surrounding text in bright blue text.

In James Hughes et al. v. American Strategic Insurance Corp et al., No. 3:24-cv-05114-DGE, United States District Court (February 14, 2025) the USDC resolved the dispute.

The court’s reasoning focused on two main points:

1 whether the ...

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February 19, 2025
Post Procurement Fraud Prevents Rescission

Rescission in Michigan Requires Preprocurement Fraud
Post 4999

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Lie About Where Vehicle Was Garaged After Policy Inception Not Basis for Rescission

This appeal turns on whether fraud occurred in relation to an April 26, 2018 renewal contract for a policy of insurance under the no-fault act issued by plaintiff, Encompass Indemnity Company (“Encompass”).

In Samuel Tourkow, by David Tourkow v. Michael Thomas Fox, and Sweet Insurance Agency, formerly known as Verbiest Insurance Agency, Inc., Third-Party Defendant-Appellee. Encompass Indemnity Company, et al, Nos. 367494, 367512, Court of Appeals of Michigan (February 12, 2025) resolved the claims.

The plaintiff, Encompass Indemnity Company, issued a no-fault insurance policy to Jon and Joyce Fox, with Michael Fox added as an additional insured. The dispute centers on whether fraud occurred in...

00:07:58
February 07, 2025
From Insurance Fraud to Human Trafficking

Insurance Fraud Leads to Violent Crime
Post 4990

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CRIMINAL CONDUCT NEVER GETS BETTER

In The People v. Dennis Lee Givens, B330497, California Court of Appeals, Second District, Eighth Division (February 3, 2025) Givens appealed to reverse his conviction for human trafficking and sought an order for a new trial.

FACTS

In September 2020, Givens matched with J.C. on the dating app “Tagged.” J.C., who was 20 years old at the time, had known Givens since childhood because their mothers were best friends. After matching, J.C. and Givens saw each other daily, and J.C. began working as a prostitute under Givens’s direction.

Givens set quotas for J.C., took her earnings, and threatened her when she failed to meet his demands. In February 2022, J.C. confided in her mother who then contacted the Los Angeles Police Department. The police ...

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February 06, 2025
No Mercy for Crooked Police Officer

Police Officer’s Involvement in Insurance Fraud Results in Jail
Post 4989

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Von Harris was convicted of bribery, forgery, and insurance fraud. He appealed his conviction and sentence. His appeal was denied, and the Court of Appeals upheld the conviction.

In State Of Ohio v. Von Harris, 2025-Ohio-279, No. 113618, Court of Appeals of Ohio, Eighth District (January 30, 2025) the Court of Appeals affirmed the conviction.

FACTUAL BACKGROUND

On January 23, 2024, the trial court sentenced Harris. The trial court sentenced Harris to six months in the county jail on Count 15; 12 months in prison on Counts 6, 8, 11, and 13; and 24 months in prison on Counts 5 and 10, with all counts running concurrent to one another for a total of 24 months in prison. The jury found Harris guilty based on his involvement in facilitating payments to an East Cleveland ...

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February 05, 2025
EXCUSABLE NEGLECT SUFFICIENT TO DISPUTE ARBITRATION LATE

Read the full article at https://lnkd.in/gRyw5QKG, see the full video at https://lnkd.in/gtNWJs95 and at https://lnkd.in/g4c9QCu3, and at https://zalma.com/blog.

To Dispute an Arbitration Finding Party Must File Dispute Within 20 Days
Post 4988

EXCUSABLE NEGLECT SUFFICIENT TO DISPUTE ARBITRATION LATE

In Howard Roy Housen and Valerie Housen v. Universal Property & Casualty Insurance Company, No. 4D2023-2720, Florida Court of Appeals, Fourth District (January 22, 2025) the Housens appealed a final judgment in their breach of contract action.

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The Housens filed an insurance claim with Universal, which was denied, leading them to file a breach of contract action. The parties agreed to non-binding arbitration which resulted in an award not

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