It is the Obligation of an Insured to Prove his Claim
Post 5084
See the full video at https://lnkd.in/gA_JbKCA and at https://lnkd.in/gdCQcUYJ and at https://zalma.com/blog plus more than 5050 posts.
Theft Claim Insufficient to Allow Total Gutting of Structure
Posted on May 28, 2025 by Barry Zalma
In Seviiri Bunjo v. State Farm Fire And Casualty Company, No. 1-24-1010, 2025 IL App (1st) 241010-U, Court of Appeals of Illinois, First District, First Division (May 19, 2025), an attempt to gain payment to remodel building failed when the insurer refused to pay for non-covered claims.
Seviiri Bunjo sued for declaratory judgment against State Farm Fire and Casualty Company (State Farm) after a break-in at his property in Chicago on May 31, 2019. Bunjo sought additional insurance proceeds for incident-related losses and lost rental income. The circuit court granted summary judgment in favor of State Farm, finding that Bunjo failed to show the damages estimate was inaccurate or that State Farm violated the terms of the insurance policy.
FACTUAL BACKGROUND
The court found that Bunjo’s contractor, Sean Rogers, provided an estimate for a full gut rehab of the property rather than just for damages from the break-in. Additionally, Bunjo’s public adjuster, Vito Misceo, admitted that he could not accurately assess the damages because the property had already been gutted.
Regarding lost rental income, the court noted that Bunjo was under a court order prohibiting him from renting, using, leasing, or occupying the property at the time of the break-in. Therefore, State Farm was not obligated to pay for lost rents or additional living expenses.
In summary, the appellate court affirmed the circuit court’s decision to grant summary judgment in favor of State Farm, finding no merit in Bunjo’s arguments. The circuit court properly entered summary judgment in favor of the insurer where the insured failed to show the damages estimate was inaccurate or that the insurer violated the terms of the insurance policy.
State Farm met its initial burden of production by establishing that plaintiff lacks sufficient evidence to prove his claim. This shifted the burden of proof to plaintiff and the court found that “plaintiff *** failed to bring forward any additional evidence regarding the extent of the initial Incident-related losses,” and therefore, “there is no genuine issue of material fact on the extent of initial losses.”
ANALYSIS
Summary judgment should be granted when, as here, the pleadings, admissions on file, depositions and any affidavits, construed strictly against the moving party, reveal no genuine issue of material fact so that the movant is entitled to judgment as a matter of law.
Because an insurance policy is a contract, the court applies general rules of contract interpretation to the policy. If the words employed in the contract are clear and unambiguous, as is the case here, they must be given their plain, ordinary and popular meaning
Plaintiff was planning to do a full gut rehab of the Property before the break-in occurred. What’s more, plaintiff failed to include appropriate citations to his arguments on these issues on appeal. As a result, the appellate court affirmed the circuit court’s judgment, concluding that Bunjo did not present sufficient evidence to prove his claim.
ZALMA OPINION
Insurance is a contract that is designed to indemnify an insured for losses due to an insured against anYfortuitous event. In this case a burglary did some damage to the structure but did not destroy the structure or make it impossible to repair. Rather than seek repair only of the damage caused by the thieves Bunjo sought to have State Farm pay for what he planned before the loss, a full gutting of the property and reconstruction. The court felt it sufficient to dismiss the suit but, in my opinion, the trial court or the appellate court should have reported Bunjo to the Department of Justice for attempted insurance fraud.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.
Subscribe to my substack at https://barryzalma.substack.com/subscribe
Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://lnkd.in/gwEYk.
Concurrent Cause Doctrine Does Not Apply When all Causes are Excluded
Post 5119
Death by Drug Overdose is Excluded
See the full video at https://lnkd.in/geQtybUJ and at https://lnkd.in/g_WNfMCZ, and at https://zalma.com/blog plus more than 5100 posts.
Southern Insurance Company Of Virginia v. Justin D. Mitchell, et al., No. 3:24-cv-00198, United States District Court, M.D. Tennessee, Nashville Division (October 10, 2024) Southern Insurance Company of Virginia sought a declaratory judgment regarding its duty to defend William Mitchell in a wrongful death case pending in California state court.
KEY POINTS
1. Motion for Judgment on the Pleadings: The Plaintiff moved for judgment on the pleadings, which was granted in part and denied in part.
2. Duty to Defend: The court found that the Plaintiff has no duty to defend William Mitchell in the California case due to a specific exclusion in the insurance policy.
3. Duty to Indemnify: The court could not determine at this stage whether the Plaintiff had a duty to ...
GEICO Sued Fraudulent Health Care Providers Under RICO and Settled with the Defendants Who Failed to Pay Settlement
See the full video at https://lnkd.in/gDpGzdR9 and at https://lnkd.in/gbDfikRG, and at https://zalma.com/blog plus more than 5100 posts.
Post 5119
Default of Settlement Agreement Reduced to Judgment
In Government Employees Insurance Company, Geico Indemnity Company, Geico General Insurance Company, and Geico Casualty Company v. Dominic Emeka Onyema, M.D., DEO Medical Services, P.C., and Healthwise Medical Associates, P.C., No. 24-CV-5287 (PKC) (JAM), United States District Court, E.D. New York (July 9, 2025)
Plaintiffs Government Employees Insurance Company and other GEICO companies (“GEICO”) sued Defendants Dominic Emeka Onyema, M.D. (“Onyema”), et al (collectively, “Defendants”) alleging breach of a settlement agreement entered into by the parties to resolve a previous, fraud-related lawsuit (the “Settlement Agreement”). GEICO moved the court for default judgment against ...
ZIFL – Volume 29, Issue 14
Post 5118
See the full video at https://lnkd.in/geddcnHj and at https://lnkd.in/g_rB9_th, and at https://zalma.com/blog plus more than 5100 posts.
You can read the full 20 page issue of the July 15, 2025 issue at https://lnkd.in/giaSdH29
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
This issue contains the following articles about insurance fraud:
The Historical Basis of Punitive Damages
It is axiomatic that when a claim is denied for fraud that the fraudster will sue for breach of contract and the tort of bad faith and seek punitive damages.
The award of punitive-type damages was common in early legal systems and was mentioned in religious law as early as the Book of Exodus. Punitive-type damages were provided for in Babylonian law nearly 4000 years ago in the Code of Hammurabi.
You can read this article and the full 20 page issue of the July 15, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/07/ZIFL-07-15-2025.pdf
Insurer Refuses to Submit to No Fault Insurance Fraud
...
Rulings on Motions Reduced the Issues to be Presented at Trial
Read the full article at https://lnkd.in/gwJKZnCP and at https://zalma/blog plus more than 5100 posts.
CASE OVERVIEW
In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.
FACTS
Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.
Prior to trial Bernier had three remaining claims against State Farm:
1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.
Both Bernier and State Farm dispositive motions before ...
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
See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.
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 ...
