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September 16, 2025
There is no Excuse for Lying to an Insurer

Breach of Material Condition for Monitored Fire Alarm Voids Coverage

See the full video at https://rumble.com/v6z0zh4-there-is-no-excuse-for-lying-to-an-insurer.html and at https://youtu.be/6PhLIpzBnQw, and at https://zalma.com/blog plus more than 5150 posts.

No Monitored Fire Alarm: No Coverage
Post 5191

In Northfield Insurance Co. v. Michigan 32, LLC, No. 24-CV-12822, United States District Court, E.D. Michigan, Southern Division (September 10, 2025) Defendant Michigan 32, LLC’s (MI 32) moved the court for reconsideration of the Court’s Opinion and Order granting summary judgment to Plaintiff Northfield Insurance Company (Northfield).

The matter arose out of a commercial insurance coverage dispute wherein Northfield denied MI 32’s fire loss claim. The Court granted summary judgment in favor of Northfield on its Declaratory Judgment action.

THE ORIGINAL DECISION

The Protective Safeguard Endorsement

The Court held that MI 32’s admitted failure to comply with its Policy’s Protective Safeguard Endorsement (“PSE”), requiring that the insured building be protected by a centrally-monitored fire alarm, which was a condition precedent to coverage, precluded coverage for the fire loss under the PSE terms and fire loss exclusion. Second, the Policy was void ab initio where it was issued in reliance on MI 32’s undisputed material misrepresentations in its application, i.e., that it had an ADT-monitored fire alarm when its principal later admitted it never did. MI 32 now maintains the Court granted Northfield’s motion without addressing MI 32’s waiver and estoppel defenses.

The Motion for Reconsideration

The local rules of this district no longer allow a party to file a motion for reconsideration of final orders or judgments. Motions to alter or amend judgment pursuant to Rule 59(e) may be granted only if there is a clear error of law, newly discovered evidence, an intervening change in controlling law, or to prevent manifest injustice. While Rule 59(e) permits a court to alter or amend a judgment, it may not be used to relitigate old matters, or to raise arguments or present evidence that could have been raised prior to the entry of judgment.

Rule 60(b) allows a court to relieve a party from a final judgment, order, or proceeding for the following reasons:

1 mistake, inadvertence, surprise, or excusable neglect;
2 newly discovered evidence that, with reasonable diligence, could not have been discovered in time to move for a new trial under Rule 59(b);
3 fraud (whether previously called intrinsic or extrinsic), misrepresentation, or misconduct by an opposing party;
4 the judgment is void;
5 the judgment has been satisfied, released, or discharged; it is based on an earlier judgment that has been reversed or vacated; or applying it prospectively is no longer equitable; or
6 any other reason that justifies relief.

In its response to Northfield’s motion for summary judgment, MI 32 argued that Northfield waived, or should be estopped from asserting, coverage preclusion or policy rescission because Northfield knew or should have known that MI 32 did not have an automatic fire alarm system. One basis of Northfield’s alleged knowledge was an August 25, 2022 phone conversation between MI 32’s principal and Traveler’s Risk Control Consultant Melissa Ellison, characterized by MI 32 as an “inspection,” which took place months after the Policy was issued.

ANALYSIS

The Court expressly found that MI 32 produced no evidence to contradict the Northfield underwriter’s affidavit attesting to the fact that Northfield did not know there was no automatic fire alarm system at the subject property when it issued the policies, and that it would not have issued the polices to MI 32 had it known.

The Court did not commit a clear error of law, or a manifest injustice, nor is there any basis to conclude that this an “unusual and extreme situation[] where principles of equity mandate relief.” MI 32 fails to satisfy its burden under Rule 59(e) or 60(b) and merely rehashes arguments contained in its responsive pleading that were already considered by the Court.

Defendant’s motion for reconsideration or rehearing was DENIED.

ZALMA OPINION

The covenant of good faith and fair dealing implied in all insurance contracts applies equally to the insured as it does to the insurer. In this case the insured blatantly lied on its application for insurance that it had a monitored fire alarm system that, after the fire, the insured admitted there was no alarm. The policy could have been rescinded for that lie and the endorsement, a condition precedent to coverage, eliminated the coverage. Therefore there was no coverage either way and the motion for reconsideration was a waste of time.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:07:35
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May 01, 2026
Zalma’s Insurance Fraud Letter – May 1, 2026

Happy Law Day

ZIFL – Volume 30, Issue 9 – May 1, 2026

Read the full article at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-may-1-2026-barry-zalma-esq-cfe-2tywc, see the video at at and at https://zalma.com/blog plus more than 5300 posts.

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

ZIFL – Volume 30, Issue 9 – May 1, 2026

Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year and is written by Barry Zalma.

DOJ Creates National Fraud Enforcement Division

Will the Feds Take on Insurance Fraud? Possibly as Part of a National Anti-Fraud Effort

On April 7, 2026, the Acting Attorney General, Todd Blanche, issued a memorandum establishing the Department of Justice National Fraud Enforcement Division (NFED). The memo describes an ambitious, but perhaps redundant, vision for this ...

00:08:23
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April 30, 2026
The Efficient Proximate Cause Doctrine Saves a Claim

When Abalone Died As a Result of Multiple Causes The Efficient Proximate Cause Requires Payment

Post number 5345

Read the full article at https://www.linkedin.com/pulse/efficient-proximate-cause-doctrine-saves-claim-barry-zalma-esq-cfe-yndlc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.

In American Abalone Farms, LLC v. Star Insurance Company et al., H052643, California Court of Appeals, Sixth District (April 27, 2026) the Court of Appeals dealt with an insurance coverage issue that required application of the efficient proximate cause doctrine.

FACTS

American Abalone Farms, LLC ("American Abalone" ) operates an aquaculture farm in Santa Cruz County, California, raising abalone in tanks. In August 2020, the CZU Lightning Complex Fires led to a prolonged power outage and road closures near the farm. As a result, the farm’s water pumps failed, causing the death of most of the ...

00:08:38
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April 29, 2026
Breach of a Specific Condition Precedent Is a Complete Defense

Breach of a Specific Condition Precedent Is a Complete Defense

See the video at and at and at https://zalma.com/blog plus more than 5300 posts.

In United Services Automobile Association and State Farm Mutual Automobile Insurance Company v. Anthony Wenzell, 2026 CO 25 (Colo. Apr. 27, 2026) Anthony Wenzell was rear-ended in a car accident. He had a significant prior 2014 accident that required back surgery.

Wenzell claimed underinsured-motorist (UIM) benefits under three policies: (1) the tortfeasor’s liability policy, (2) his own primary UIM policy with State Farm, and (3) an excess UIM policy issued by USAA (under his brother’s policy, which contained an “other insurance” clause making USAA’s coverage excess over any collectible insurance).

After receiving the claims, both USAA and State Farm repeatedly requested that Wenzell execute comprehensive medical-release authorizations so they could obtain his full medical records and ...

00:11:27
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12 hours ago

It is Fraud to Make the Same Claim Twice

Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.

Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages

Post number 5347

No One is Entitled to be Paid for the Same Loss Twice

In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.

BACKGROUND

In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.

PROCEDURAL HISTORY

State Farm filed motion for summary...

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12 hours ago

It is Fraud to Make the Same Claim Twice

Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.

Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages

Post number 5347

No One is Entitled to be Paid for the Same Loss Twice

In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.

BACKGROUND

In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.

PROCEDURAL HISTORY

State Farm filed motion for summary...

post photo preview
April 30, 2026
Investigation of First Party Property Claims

What Must be Done after Notice of a Claim is Received by the Insurer

Read the full article at https://lnkd.in/gzvvdkMZ and at https://zalma.com/blog.

Below you will read from this post until you reach the the end of this blog post as the free part of an Excellence in Claims Handling post. To read the full article and receive all articles for members of Excellence in Claims Handling you should consider joining as a paid member to get full access to articles for members only, to our news, analysis, insurance coverage, claims, insurance fraud and insurance webinars, by clicking at the subscription link below.

A first party property policy does not insure property: it insures a person, partnership, corporation or other entity against the risk of loss of the property. Before an insured can make a claim for indemnity under a policy of first party property insurance the insured must prove that there was damage to property the risk of loss of which was insured by the policy. The obligation imposed on the insured ...

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