Lie on an Application About Primary Residence is Ground for Rescission
Post 4896
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Plaintiff Homesite Insurance Company's (Homesite) moved for Summary Judgment seeking a judicial declaration that it is entitled to rescission of Defendant Zhen Jiang's homeowners' insurance policy and enter summary judgment in its favor on Mr. Jiang's bad faith counterclaims.
In Homesite Insurance Company v. Zhen Jiang, No. CV-21-00554-TUC-JGZ, United States District Court, D. Arizona (September 16, 2024) the USDC explained an insurer's right to rescission.
INTRODUCTION
The USDC described this case as "an insurance fraud case."
Homesite asserts that Mr. Jiang misrepresented that the house located at 7617 East Snyder Road, Tucson, AZ 85750 (the Property) was his primary residence. Homesite relied on Mr. Jiang's representation in issuing the homeowners' insurance policy (the Policy); and Mr. Jiang's misrepresentation was material because Homesite does not, and would not, insure a vacant home.
Mr. Jiang owns properties in Arizona and Texas. In early 2018, Mr. Jiang bought the Property, a five-bedroom single-family residence located on four acres at 7617 East Snyder Road. The Property had been vacant since the previous owners lost the Property to foreclosure in 2014.
Mr. Jiang's Insurance Application And Policy
In November 2019, Mr. Jiang applied for homeowners' insurance for the Property. In his application, Mr. Jiang represented that the Property was his primary residence and that the information provided in the application was truthful and accurate.
Homesite warned Mr. Jiang, after accepting him as an insured, to review the Declarations page and check the description of the dwelling, and occupancy and if any of this information needs to be corrected, Jiang must advise Homesite within 30 days of receipt.
The Pima County Sheriff's March 21, 2020 Report
On March 21, 2020, the Pima County Sheriff's Department responded to a call of vandalism at the Property. Vandals had set off fireworks inside the Property, graffitied and put holes in the walls, started fires, and broke numerous windows.
Mr. Jiang's Neighbor's Statements
The March 21, 2020 call to police was made by neighbor Morgan Hay stated that the damage to the Property possibly occurred over New Years. Mr. Hay informed officers that Mr. Jiang “would show up from time to time and ask Mr. Hay to check on the house periodically; however, nobody had occupied that residence since it was foreclosed upon in 2014.” Similar responses were testified to by multiple neighbors.
Mr. Jiang's Statements Regarding Occupancy
Mr. Jiang provided numerous inconsistent statements as to when, if ever, he lived at the Property. In his Opposition, he states that he lived in the home from late 2019 until early 2020, and that the home was not vacant for more than 60 days prior to the March 21, 2020 fire.
DISCUSSION
Fraudulent misstatements, omissions, or concealment of facts can be established by proving either legal fraud or actual fraud. Legal fraud exists if the question asked in an insurance application: (1) is one where the facts are within the personal knowledge of the insured; (2) are such that the insurer would naturally have contemplated that the answers represented the actual facts; and (3) the answers are false. Legal fraud does not require an intent to deceive.
Homesite established that the Property was not Mr. Jiang's primary residence. No reasonable juror could conclude otherwise based upon the evidence that he lived elsewhere, the condition of the Property, the reports of his neighbors, and the fact that he was apparently unaware of the vandalism occurring on the Property until late October 2020.
Mr. Jiang is not credible for the additional reason that he concealed his lease at the 7th Street Apartment during discovery.
Homesite Did Not Act In Bad Faith In Investigating And Processing Mr. Jiang's Claim.
The Court will enter summary judgement in favor of Homesite on Mr. Jiang's bad faith counterclaims. The USDC concluded that Homesite is entitled to rescission of the Policy and entry of judgment on Mr. Jiang's counterclaims.
ZALMA OPINION
Insurance is a business of utmost good faith where neither party to the contract will do anything to deprive the other of the benefits of the contract. Mr. Jiang lied on his application and continued to lie as he pursed his claim. The lies were material since the insurer would never issue a homeowners policy to a vacant property, especially one that had been vacant and vandalized before he bought the property. This liar will not prosper from his fraud and the court should refer Mr. Jiang to the office of the US Attorney to prosecute him for fraud.
(c) 2024 Barry Zalma & ClaimSchool, Inc.
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Jury’s Findings Interpreting Insurance Contract Affirmed
Post 5105
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Madelaine Chocolate Novelties, Inc. (“Madelaine Chocolate”) appealed the district court’s judgment following a jury verdict in favor of Great Northern Insurance Company (“Great Northern”) concerning storm-surge damage caused by “Superstorm Sandy” to Madelaine Chocolate’s production facilities.
In Madelaine Chocolate Novelties, Inc., d.b.a. The Madelaine Chocolate Company v. Great Northern Insurance Company, No. 23-212, United States Court of Appeals, Second Circuit (June 20, 2025) affirmed the trial court ruling in favor of the insurer.
BACKGROUND
Great Northern refused to pay the full claim amount and paid Madelaine Chocolate only about $4 million. In disclaiming coverage, Great Northern invoked the Policy’s flood-exclusion provision, which excludes, in relevant part, “loss or damage caused by ....
Failure to Name a Party as an Additional Insured Defeats Claim
Post 5104
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Contract Interpretation is Based on the Clear and Unambiguous Language of the Policy
In Associated Industries Insurance Company, Inc. v. Sentinel Insurance Company, Ltd., No. 23-CV-10400 (MMG), United States District Court, S.D. New York (June 16, 2025) an insurance coverage dispute arising from a personal injury action in New York State Supreme Court.
The underlying action, Eduardo Molina v. Venchi 2, LLC, et al., concerned injuries allegedly resulting from a construction accident at premises owned by Central Area Equities Associates LLC (CAEA) and leased by Venchi 2 LLC with the USDC required to determine who was entitled to a defense from which insurer.
KEY POINTS
Parties Involved:
CAEA is insured by Associated Industries Insurance Company, Inc. ...
Exclusion Establishes that There is No Duty to Defend Off Site Injuries
Post 5103
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Attack by Vicious Dog Excluded
In Foremost Insurance Company, Grand Rapids, Michigan v. Michael B. Steele and Sarah Brown and Kevin Lee Price, Civil Action No. 3:24-CV-00684, United States District Court, M.D. Pennsylvania (June 16, 2025)
Foremost Insurance Company (“Foremost”) sued Michael B. Steele (“Steele”), Sarah Brown (“Brown”), and Kevin Lee Price (“Price”) (collectively, “Defendants”). Foremost sought declaratory relief in the form of a declaration that
1. it owes no insurance coverage to Steele and has no duty to defend or indemnify Steele in an underlying tort action and
2. defense counsel that Foremost has assigned to Steele in the underlying action may withdraw his appearance.
Presently before the Court are two ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:
Health Care Fraud Trial Results in Murder for Hire of Witness
To Avoid Conviction for Insurance Fraud Defendants Murder Witness
In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...
Professional Health Care Services Exclusion Effective
Post 5073
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This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.
In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:
Insurance Coverage Dispute:
Travelers issued a Commercial General Liability ...
A Heads I Win, Tails You Lose Story
Post 5062
Posted on April 30, 2025 by Barry Zalma
"This is a Fictionalized True Crime Story of Insurance Fraud that explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help everyone to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime."
Immigrant Criminals Attempt to Profit From Insurance Fraud
People who commit insurance fraud as a profession do so because it is easy. It requires no capital investment. The risk is low and the profits are high. The ease with which large amounts of money can be made from insurance fraud removes whatever moral hesitation might stop the perpetrator from committing the crime.
The temptation to do everything outside the law was the downfall of the brothers Karamazov. The brothers had escaped prison in the old Soviet Union by immigrating to the United...
