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.
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The Largest Residential Burglary of All Time
Post 5407
Fraud & the Fear of Bad Faith Suits
Posted on July 22, 2026 by Barry Zalma
See the full video at https://lnkd.in/gWQQEySW and at https://lnkd.in/gyhdK6wv
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.
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.
After ...
Chutzpah is not Enough
Post 5397
Posted on July 20, 2026 by Barry Zalma
See the video and at https://lnkd.in/gNUs2XzT and at https://lnkd.in/g2MawyzX
Magistrate Issues a Search Warrant if there is a Fair Probability that Contraband or Evidence of a Crime will be Found in a Particular Place.
In United States Of America v. Frank Suess, et al., CRIMINAL No. 3:24-308, United States District Court, M.D. Pennsylvania (July 16, 2026) a federal grand jury indicted Frank Suess, Melissa Driscoll, and others in a 55-count health care fraud and anti-kickback prosecution arising from an alleged scheme involving medically unnecessary prescription “foot baths.”
As part of the investigation, the FBI obtained an August 19, 2022 warrant to search Driscoll’s Sterling Pharmacy Yahoo email account for emails from January 1, 2018 through December 31, 2020. Driscoll moved to suppress the resulting evidence, arguing that the warrant lacked probable cause, was overbroad, and rested on material misstatements and omissions.
LAW:
The ...
Fraud Shouldn’t Pay
Post 5396
See the video and at https://rumble.com/v7ctgmq-the-great-jewel-theft.html at https://youtu.be/aRbQ2sJfGwA
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.
One month after the policy was ...
Day Care Owner Loses Subsidies Because She Criticized State
Post 5421
Posted on August 11, 2026 by Barry Zalma
First Amendment Right Will be Allowed to Go to Trial
In Betsey J. Grant v. Maine State Department Of Heath And Human Services, No. 1:25-cv-00490-JAW, United States District Court, D. Maine (August 6, 2026), Betsey J. Grant, a licensed childcare provider and operator of Tiny Tikes Daycare in Trenton, Maine, sued Maine DHHS and several employees after she publicly criticized DHHS before Maine’s Government Oversight Committee and alleged that officials retaliated against her.
She claimed DHHS imposed and extended a conditional license, published stigmatizing information, interfered with subsidies and program funding, removed her from a food program, rescinded an expansion grant, and used biased or falsified evidence in licensing proceedings. Following the March 10, 2023, GOC testimony, Ms. Grant alleges that foster children's subsidies (approximately $30,000) were withheld; she was removed from the ...
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. 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 ...
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:
As a result, the...
