It is the Obligation of an Insured to Prove his Claim
Post 5084
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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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Anti-Public Adjuster Clause Is Effective in New York
Post number 5301
Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster
In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.
FACTS
NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...
Anti-Public Adjuster Clause Is Effective in New York
Post number 5301
Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster
In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.
FACTS
NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...
Proof of Highly Contaminated Water is Required for Extra Payments
Post number 5300
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In Lee Lifeng Hsu and Jane Yuchen Hsu v. State Farm Fire And Casualty Company, C. A. No. N24C-09-020 CLS, Superior Court of Delaware (February 27, 2026) a claim to State Farm who paid approximately $61,000 after assessments but denied coverage for additional items including ceramic tiles, the kitchen floor ceiling, underlayment plywood, and numerous personal property items resulted in suit by the Hsu’s acting in pro per.
Facts
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Insurance Condition Requires Following the Intent of the Parties
Post number 5307
Principles of Contract Interpretation Compels Reading Contract as Written
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In Eastside Floor Supplies, Ltd. v. SCS Agency, Inc., Hanover Insurance Company, et al., No. 2024-01501, Index No. 609883/19, 2026 NY Slip Op 01488, Supreme Court of New York, Second Department (March 18, 2026)
In May 2019, a fire damaged business personal property belonging to the plaintiffs, which was stored in portable storage containers at their Manhattan premises. At the time of the fire, the plaintiffs were insured under a businessowners insurance policy (BOP) issued by the defendant Hanover Insurance Company which provided general coverage for business personal property, and which included a specific extension for “Business Personal Property Temporarily in Portable Storage Units” (the portable storage ...
ERISA Saves Fraudulent Claims Suit
Post number 5306
Read the full article at https://www.linkedin.com/pulse/failure-provide-well-pled-facts-defeats-most-action-zalma-esq-cfe-b4zuc and at https://zalma.com/blog plus more than 5300 posts.
Allegations of Fraudulent Insurance Billing Must be Pleaded with Specificity
In Genesis Laboratory Management LLC v. United Healthcare Services, Inc. and Oxford Health Plans, Inc., No. 21cv12057 (EP) (JSA), United States District Court, D. New Jersey (March 13, 2026) Genesis Laboratory Management LLC (“Genesis”), a New Jersey-based molecular diagnostic and anatomic pathology laboratory, provided COVID-19 related testing services and submitted claims for reimbursement as an out-of-network provider to United Healthcare Services, Inc. (“United”) and Oxford Health Insurance, Inc. (“Oxford”). Metropolitan Healthcare Billing, LLC (“Metropolitan”), owned by the same individual as Genesis, handled the billing for Genesis.
FACTUAL BACKGROUND
United and Oxford, who administer both ERISA and ...
ERISA Saves Fraudulent Claims Suit
Post number 5306
Read the full article at https://www.linkedin.com/pulse/failure-provide-well-pled-facts-defeats-most-action-zalma-esq-cfe-b4zuc and at https://zalma.com/blog plus more than 5300 posts.
Allegations of Fraudulent Insurance Billing Must be Pleaded with Specificity
In Genesis Laboratory Management LLC v. United Healthcare Services, Inc. and Oxford Health Plans, Inc., No. 21cv12057 (EP) (JSA), United States District Court, D. New Jersey (March 13, 2026) Genesis Laboratory Management LLC (“Genesis”), a New Jersey-based molecular diagnostic and anatomic pathology laboratory, provided COVID-19 related testing services and submitted claims for reimbursement as an out-of-network provider to United Healthcare Services, Inc. (“United”) and Oxford Health Insurance, Inc. (“Oxford”). Metropolitan Healthcare Billing, LLC (“Metropolitan”), owned by the same individual as Genesis, handled the billing for Genesis.
FACTUAL BACKGROUND
United and Oxford, who administer both ERISA and ...
