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April 04, 2025
Insurer Who Sues Insured for Fraud Without Evidence Should be Punished

Exemplary Damages Available for Fraud, Malice, or Willful and Wanton Conduct

Post 5039

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Lack of Evidence Accusing Insured of Fraud Exposes Insurer to Punitive Damages

In Shalz Construction LLC, a Colorado limited liability company; and Bradley Shalz, individually v. Great Lakes Insurance, SE f/k/a Great Lakes Reinsurance UK PLC, a foreign corporation, Civil Action No. 22-cv-03005-NYW-NRN, United States District Court, D. Colorado (March 31, 2025) the Court was asked by Plaintiffs Shalz Construction, LLC and Bradley Shalz’s (collectively, “Plaintiffs” or “Shalz”) for Leave to Amend to Seek Exemplary Damages (“Motion to Amend”).

Background

The case has a complicated history, originating from third-party claims that Great Lakes asserted against Shalz in an earlier lawsuit involving Pinon Sun ConLack of Evidence Accusing Insured of Fraud Exposes Insurer to Punitive Damages

In Shalz Construction LLC, a Colorado limited liability company; and Bradley Shalz, individually v. Great Lakes Insurance, SE f/k/a Great Lakes Reinsurance UK PLC, a foreign corporation, Civil Action No. 22-cv-03005-NYW-NRN, United States District Court, D. Colorado (March 31, 2025) the Court was asked by Plaintiffs Shalz Construction, LLC and Bradley Shalz’s (collectively, “Plaintiffs” or “Shalz”) for Leave to Amend to Seek Exemplary Damages (“Motion to Amend”).

Background

The case has a complicated history, originating from third-party claims that Great Lakes asserted against Shalz in an earlier lawsuit involving Pinon Sun Condominium Association, Inc. Great Lakes alleged that Shalz conspired with Pinon Sun to commit insurance fraud by submitting inflated estimates for roofing repairs.

Legal Proceedings

Judge Christine M. Arguello dismissed the racketeering claims against Shalz and later entered summary judgment in Shalz’s favor on all remaining claims. The court concluded that Great Lakes had relied on its own contractors’ estimates rather than any information provided by Shalz.

Current Lawsuit

Shalz sued Great Lakes for malicious prosecution, claiming actual out-of-pocket damages of approximately $200,000 and seeking damages for lost profits, business opportunities, and damage to their reputation, estimated at approximately $3 million.

Motion to Amend

Shalz asserted that Great Lakes acted with fraud, malice, or willful and wanton conduct in bringing the conspiracy and fraud claims against Shalz, justifying a jury awarding exemplary damages.
Legal Standard

Under Colorado law, exemplary damages are appropriate in civil actions where the injury is attended by circumstances of fraud, malice, or willful and wanton conduct.

ANALYSIS

Plaintiffs have provided evidence that Great Lakes pursued the lawsuit against Shalz maliciously and with evil intent, primarily to exert settlement pressure. Therefore, the Court granted Plaintiffs’ Motion for Leave to Amend to Seek Exemplary Damages.

Legal Standard For Allowing Exemplary Damages Under Colorado Law

A claim for exemplary damages under Colorado law is appropriate in all civil actions in which damages are assessed by a jury for a wrong done to a person or to personal or real property, where the injury complained of is attended by circumstances of fraud, malice, or willful and wanton conduct.

Willful and wanton conduct is defined as conduct purposefully committed which the actor must have realized as dangerous, done heedlessly and recklessly, without regard to consequences, or of the rights and safety of others, particularly the plaintiff.

The statutory requirements are met where the defendant is conscious of his conduct and the existing conditions and knew or should have known that injury would result. Exemplary damages are intended to punish and penalize a defendant for certain wrongful and aggravated conduct and to serve as a warning to other possible offenders

CONCLUSION

Great Lakes brought claims against Shalz for which Great Lakes could not even muster any non-speculative allegations or utterly failed to provide any evidence of, for example, reliance or damages.Plaintiffs brought forward prima facie evidence that Great Lakes sued Shalz for fraud, civil theft with the knowledge that there was little to no support for those claims because Great Lakes had never relied on or been damaged by the alleged conduct.

Plaintiffs’ Motion for Leave to Amend to Seek Exemplary Damages was GRANTED.

ZALMA OPINION

Insurance fraud is both a crime and a tort. If an insured commits fraud any claim owed under an insurance policy becomes void and noncollectable. However, accusing an insured of fraud without evidence is wrongful and can take what an insurer thought was a good defense to a claim into an obvious loss and provide the insured with the ability to punish the insurer. Great Lakes learned that its suit against Shalz for fraud and civil theft with the knowledge that there was little to no support for those claims because Great Lakes had never relied on or been damaged by the alleged conduct, the court allowed the plaintiffs to amend their suit to include a claim seeking exemplary damages.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:07:55
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Post 5396

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This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help 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.

The Insured purchased, for the first time in his life, a policy of Personal Articles Floater Insurance (PAF) scheduling $125,000 worth of ladies jewelry. He advised the insurer that the jewelry was always kept in a class E safe at his residence. He also told the insurer that he was employed full time as the owner of a gasoline service station and that he had never been canceled or suffered a previous loss.

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Post 5421

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In Union Mutual Fire Insurance Company v. 844 Knickerbocker, LLC, et al. No. 2024-10359, Index No. 602824/22, 2026 NY Slip Op 04789, Supreme Court of New York, Second Department (July 29, 2026) Union Mutual Fire Insurance Company issued commercial insurance policies to 844 Knickerbocker, LLC, and Sanjaya Mallick based on applications stating that the insured property contained two apartment units. After an underlying personal injury action was filed, Union Mutual determined that the property actually contained three apartment units and rescinded the policies on the ground that the defendants had made a material misrepresentation in the applications.
LAW:

A misrepresentation is material if the insurer would not have issued the same policy, or would have issued it only on different terms, had the true ...

post photo preview
August 05, 2026
It Doesn’t Pay to Lie in an Application for Insurance

Rescission for Material Misrepresentation
Post 5418

Posted on August 5, 2026 by Barry Zalma

An Insurer May Rescind An Insurance Policy Where The Applicant Made A Material Misrepresentation In The Application.

In Union Mutual Fire Insurance Company v. 844 Knickerbocker, LLC, et al. No. 2024-10359, Index No. 602824/22, 2026 NY Slip Op 04789, Supreme Court of New York, Second Department (July 29, 2026) Union Mutual Fire Insurance Company issued commercial insurance policies to 844 Knickerbocker, LLC, and Sanjaya Mallick based on applications stating that the insured property contained two apartment units.

LAW:

A misrepresentation is material if the insurer would not have issued the same policy, or would have issued it only on different terms, had the true facts been disclosed. To establish materiality as a matter of law, the insurer must submit documentation of its underwriting practices, such as manuals, guidelines, bulletins, or rules addressing similar risks.

DISCUSSION/ANALYSIS:

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