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March 13, 2025
Lies on Application Voids Policy

Rescission is a Remedy for Fraud in an Application for Insurance

Read the full article at https://lnkd.in/g2b9zTwB, see the full video at https://lnkd.in/guvjUW7i and at https://lnkd.in/gtrd6uHQ and https://zalma.com/blog plus more than 5000 posts.

Post 5018

Beach Cruiser, LLC and Flyway Management, LLC own and manage multiple rental units. In 2021, Plaintiff Mt. Hawley Insurance Company (“Mt. Hawley”) issued Defendants an insurance policy (the “Policy”). The Policy covered bodily injury liability in connection with their units but excluded coverage in the event that Defendants provided “incorrect, false, inaccurate or incomplete information” in their application for insurance.

In Mt. Hawley Insurance Company v. Beach Cruiser, LLC, et al., No. 1:22-cv-10354-GHW, United States District Court, S.D. New York (March 6, 2025) the court applied New York’s law of rescission.

BACKGROUND

Plaintiff Mt. Hawley Insurance Company (“Mt. Hawley”) is an insurer, Defendant Beach Cruiser, LLC (“Beach Cruiser”) owns multiple residential properties and rents them out to tenants. It owns a residential property located at 146 President Street, Unit C, Charleston, South Carolina (the “Property”). Defendant Flyway Management, LLC (“Flyway,” and together with Beach Cruiser, “Defendants”) managed the Property on behalf of Beach Cruiser at all relevant times.. Nonparty USI Insurance Services (“USI”) served as an insurance broker for Beach Cruiser with respect to the Policy.

THE REPRESENTATIONS

Defendants’ application for the Policy checked “No” in response to the question “Are any properties rented by the day or by the week?”

Contrary to the statement in the application Defendants had been renting some of their units by the day or by the week for years.

THE ACCIDENT & INJURIES

On July 23, 2022, two of the tenants allegedly fell from the second floor of the Property after a porch railing collapsed. Both tenants sought damages from Defendants for their alleged injuries. Defendants claim coverage under the Policy. Plaintiff argues that Defendants’ claims are excluded from coverage because Defendants misrepresented the Property’s rental status in their application.

INSURANCE EXCLUSIONARY CONDITION

The principal question before the Court was whether New York Insurance Law § 3105(b) (“Section 3105(b)”) modifies the parties’ agreed-upon exclusion of coverage based on Defendants’ misrepresentations. The Court concluded that it does not. It does not apply where, as here, an insured’s claim is excluded from the insurance contract by prior mutual agreement.

The Policy includes coverage for, among other things, “bodily injury liability” up to $1,000,000 per occurrence subject to the Policy’s terms and conditions. For purposes of an endorsement: “the Application(s) includes, without limitation, any application forms and any other forms, documents, or information submitted to us in connection with or relating to issuance of this policy. For purposes of this endorsement, the Application(s) is a part of this policy and is incorporated herein.”

Beach Cruiser checked the “No” box in response to the question “Are any properties rented by the day or by the week?” However, Beach Cruiser had been renting the Property through Vrbo, an online platform for short-term vacation rentals, since 2018.

On January 25, 2022, Beach Cruiser executed a three-day rental contract through Vrbo for a party to stay at the Property from July 21 to July 24, 2022. The party included Walter Patrick Humphrey and Jonathan Charles Slade.

Mr. Humphrey filed an action in South Carolina state court against Beach Cruiser and Flyway arising from his alleged injuries (the “Humphrey Action”). Mr. Slade sent Flyway a demand letter alleging various causes of action arising from his alleged injuries.

On November 14, 2022, Mt. Hawley sent Beach Cruiser a letter stating that it was rescinding the Policy.

DISCUSSION

Summary judgment is appropriate here because the Policy unambiguously excludes coverage in connection with the July 23, 2022 incident. There is only one reasonable reading of Question 3 in the Application. Defendants’ response to Question 3 was plainly false. And the Endorsement unambiguously excludes coverage if the insured provided false answers in the Application.

The Policy unambiguously excludes coverage for Defendants’ claims. New York courts have held that, where there has been a misrepresentation by an insured, the insurance company can avoid liability on the policy by showing that the misrepresentation was material.

Because enforcing the Endorsement according to its terms is not inconsistent with Section 3105(b), the Endorsement is not, as Defendants and Nationwide argue, “void . . . as a matter of public policy.”

Plaintiff’s motion for summary judgment was GRANTED and Defendants’ and Nationwide’s motions for summary judgment was DENIED. The Court declared that Plaintiff Mt. Hawley Insurance Company has no obligation under the Policy to defend or indemnify Defendants Beach Cruiser, LLC and Flyway Management, LLC in connection with the July 23, 2022 incident.

Accordingly, because the Policy unambiguously excludes claims in the event of a misrepresentation in Defendants’ application, and because Defendants’ application unambiguously misrepresented the rental status of the Property, Plaintiff’s motion for summary judgment was GRANTED and Defendants’ and Nationwide’s motions for summary judgment were DENIED.

ZALMA OPINION

Insurance is a contract of good faith that requires each party to the contract to act fairly and in good faith to each other. When one party, seeking insurance, lies about the risks faced by the insured and the property that is the subject of the proposed insurance contract, he, she or it, has misrepresented a material fact and the law of equity requires the policy to be declared void.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:10:03
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The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...

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Convicted on 29 Tax-Refund-Fraud Counts

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Post 4846

Posted on September 17, 2026 by Barry Zalma

See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.

FACTS

In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS

Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.

The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...

00:05:23
September 14, 2026
Court Enforces Fifth Amendment & Refuses to Compel Answers

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Post 5489

Posted on September 14, 2026 by Barry Zalma

Fraudster Refuses to Answer Questions About His Alleged Fraud

See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr

In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.

Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.

After Great American ...

00:05:14
September 25, 2026
Unwise for a Appellant to Represent Himself.

Inadequately Briefed Issues Defeats Appeal

Post 4852

Issues on Appeal Must be Adequately Briefed

Posted on September 25, 2026 by Barry Zalma

In Emy Ojekwe v. Connecticut Transit District Consortium, No. AC 47389, Court of Appeals of Connecticut (September 22, 2026) Emy Ojekwe alleged that he was injured on September 24, 2020, while leaving a bus operated by Connecticut Transit District Consortium, doing business as Greater Bridgeport Transit Authority.

According to his complaint, the wheelchair ramp began to rise before he had fully exited, causing his wheelchair to fall backward and allegedly injuring several parts of his body and damaging the wheelchair. The defendant denied negligence and alleged comparative negligence. After a two-day jury trial in November 2023, the jury returned a defense verdict.

The trial court denied Ojekwe’s motion to set aside the verdict and for a new trial, and he appealed.

LAW

A trial court’s refusal to set aside a verdict because of counsel’s improper remarks is reviewed for abuse of ...

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September 25, 2026
Unwise for a Appellant to Represent Himself.

Inadequately Briefed Issues Defeats Appeal

Post 4852

Issues on Appeal Must be Adequately Briefed

Posted on September 25, 2026 by Barry Zalma

In Emy Ojekwe v. Connecticut Transit District Consortium, No. AC 47389, Court of Appeals of Connecticut (September 22, 2026) Emy Ojekwe alleged that he was injured on September 24, 2020, while leaving a bus operated by Connecticut Transit District Consortium, doing business as Greater Bridgeport Transit Authority.

According to his complaint, the wheelchair ramp began to rise before he had fully exited, causing his wheelchair to fall backward and allegedly injuring several parts of his body and damaging the wheelchair.

LAW

Refusal to set aside a verdict because of counsel’s improper remarks is reviewed for abuse of discretion.

Appellate claims receiving only cursory treatment, without record citations, supporting authority, or legal analysis, are inadequately briefed.

DISCUSSION

Improper opening remarks.

Defense counsel referred to Ojekwe’s national origin,...

September 24, 2026
Restitution Sentence Affirmed

Psychiatrist Who Was Convicted of Fraud Asked the First Circuit to Reduce his Punishment
Post 4851

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Fraud to Private and Public Health Insurers Doesn’t Pay

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A jury convicted Kinrys on fourteen counts. The district court imposed a 99-month sentence, calculated intended loss at slightly more than $19 million based on billed amounts, ordered $6,537,309.59 in restitution, and ordered $6,527,391.19 in forfeiture.

At sentencing, the district court calculated Kinrys’s base offense level to be ...

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