Insured Must Reside in Dwelling to Obtain Homeowners Insurance Claim Benefits
Post 5206
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In Donald Jackson v. Spinnaker Insurance Company, Civil Action No. 22-1244, United States District Court, W.D. Pennsylvania (October 7, 2025) where Plaintiff, in his Proposed Jury Instructions and Jury Verdict Slip and his Trial Brief asserted for the first time an entitlement to equitable estoppel on grounds that Defendant’s “own rules and procedures . . . required [Defendant, through its property inspector] to confirm that the insured had moved in and begun to reside in the insured premises.”
Plaintiff asserted that Defendant’s exercise of its right to inspect the property and failure to confirm, and/or communicate its assessment of, his residency induced his justified reliance. He further asserts that were he aware that his use of the property was insufficient to coverage, he would have either altered his use or his insurance policy.
Equitable Estoppel:
The court denied the Plaintiff’s request to include a theory of equitable estoppel in the jury instruction, verdict slip, or elsewhere in the litigation. The Plaintiff’s assertion that the Defendant’s conduct reasonably induced him to stay at the subject premises less often or to forego alternative insurance was found insufficient to raise a genuine fact question of detrimental reliance. The Plaintiff’s proffer failed to identify sufficient facts to warrant the application of equitable estoppel in this litigation. Under Pennsylvania law, equitable estoppel is intended to preclude a party from depriving another of a reasonable expectation when the party inducing the expectation knew or should have known that the other would rely to their detriment upon that conduct.
Procedural Posture:
The Plaintiff did not raise the theory of equitable estoppel in the Complaint, Pretrial Statement, or during the two rounds of motions in limine. The Plaintiff first proposed the theory in recent pretrial filings and did not seek leave of court to raise this theory.
Legal Precedents:
The court referenced several legal precedents and the court noted that coverage limitations are not subject to implied waiver or estoppel in Pennsylvania .
Plaintiff’s Claim Is Without Merit
Plaintiff’s equitable estoppel theory asserts that even if Defendant’s non-residence defense has a reasonable basis, Defendant misled Plaintiff into failing to meet the residency requirement (or into foregoing other insurance) in such a way as to make enforcement of that requirement unfair. Such a theory faces substantial hurdles under Pennsylvania law.
First, the Pennsylvania Superior Court has indicated – in Wasilko v. Home Mut. Cas. Co., 232 A.2d 60 (Pa. Super. 1967) and again more recently in Gemini Insurance Company v. Meyer Jabara Hotels LLC, 231 A.3d 839 (Pa. Super. 2020) – that coverage limitations are not subject to implied waiver or estoppel in Pennsylvania.
Second, where an estoppel theory is permitted, its elements are exacting. Equitable estoppel is a doctrine of fundamental fairness intended to preclude a party from depriving another of a reasonable expectation, when the party inducing the expectation knew or should have known that the other would rely to his detriment upon that conduct. In the insurance context, there must be such conduct on the part of the insurer as would, if the insurer were not estopped, operate as a fraud on some party who has taken or neglected to take some action to his own prejudice in reliance thereon.
An insured must show (1) an inducement, whether by act, representation, or silence when one ought to speak, that causes one to believe the existence of certain facts; (2) justifiable reliance on that inducement; and (3) prejudice to the one who relies if the inducer is permitted to deny the existence of such facts.
Plaintiff’s claims were plainly insufficient to work an estoppel. Whether an insured has “moved in, taken possession” is not necessarily coextensive with whether he resides at the premises.
Court’s Findings:
The court found the Plaintiff’s claim of entitlement to equitable estoppel both procedurally flawed and without merit. The court emphasized that an insurer is not estopped to deny liability on a policy where the plaintiff was not misled by the defendant’s conduct.
Therefore, on the 7th day of October, 2025, the court ordered that Plaintiff’s recently requested inclusion of a theory of equitable estoppel was denied, and the parties were precluded from introducing evidence or argument for the purpose of supporting or opposing any contention as to Plaintiff’s entitlement to equitable estoppel as to the issue of Plaintiff’s residency.
ZALMA OPINION
Almost every homeowners insurance policy contains a condition that insures only a residence premises and requires the insured to reside in the premises. No insurer is required to establish the fact but the insured, who in applying for the insurance, warrants and declares that he or she resides in the premises. Failing to be truthful when obtaining a homeowners policy is a misrepresentation at the time of inception and if not there at the time of loss defeats coverage.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Convicted Criminal Seeks to Compel Receiver to Protect his Assets
Post number 5291
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The Work of a Court Appointed Receiver is Constitutionally Protected
In Simon Semaan et al. v. Robert P. Mosier et al., G064385, California Court of Appeals, Fourth District, Third Division (February 6, 2026) the Court of Appeals applied the California anti-SLAPP statute which protects defendants from meritless lawsuits arising from constitutionally protected activities, including those performed in official capacities. The court also considered the doctrine of quasi-judicial immunity, which shields court-appointed receivers from liability for discretionary acts performed within their official duties.
Facts
In September 2021, the State of California filed felony charges against Simon Semaan, alleging violations of Insurance Code section 11760(a) for making...
When There are Two Different Other Insurance Clauses They Eliminate Each Other and Both Insurers Owe Indemnity Equally
Post number 5289
In Great West Casualty Co. v. Nationwide Agribusiness Insurance Co., and Conserv FS, Inc., and Timothy A. Brennan, as Administrator of the Estate of Pat- rick J. Brennan, deceased, Nos. 24-1258, 24-1259, United States Court of Appeals, Seventh Circuit (February 11, 2026) the USCA was required to resolve a dispute that arose when a tractor-trailer operated by Robert D. Fisher (agent of Deerpass Farms Trucking, LLC-II) was involved in a side-impact collision with an SUV driven by Patrick J. Brennan, resulting in Brennan’s death.
Facts
Deerpass Trucking, an interstate motor carrier, leased the tractor from Deerpass Farms Services, LLC, and hauled cargo for Conserv FS, Inc. under a trailer interchange agreement. The tractor was insured by Great West Casualty Company with a $1 million policy limit, while the trailer was insured by Nationwide Agribusiness Insurance Company with a $2 million ...
Opiod Producer Seeks Indemnity from CGL Insurers
Post number 5288
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Insurers Exclude Damages Due to Insured’s Products
In Matthew Dundon, As The Trustee Of The Endo General Unsecured Creditors’ Trust v. ACE Property And Casualty Insurance Company, et al., Civil Action No. 24-4221, United States District Court, E.D. Pennsylvania (February 10, 2026) Matthew Dundon, trustee of the Endo General Unsecured Creditors’ Trust, sued multiple commercial general liability (CGL) insurers for coverage of opioid-related litigation involving Endo International PLC a pharmaceutical manufacturer.
KEY FACTS
Beginning as early as 2014, thousands of opioid suits were filed by governments, third parties, and individuals alleging harms tied to opioid manufacturing and marketing.
Bankruptcy & Settlements
Endo filed Chapter 11 in August 2022; before bankruptcy it ...
Passover for Americans
Posted on February 19, 2026 by Barry Zalma
“The Passover Seder For Americans”
For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lost the ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah. Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and wonder how did all these wonderful things come into being. Jews believe the force we call G_d created the entire universe and everything in it. Jews feel G_d is all seeing and knowing and although we can’t see Him, He is everywhere and in everyone.We understand...
Passover for Americans
Posted on February 19, 2026 by Barry Zalma
Read the full article at https://www.linkedin.com/pulse/passover-americans-barry-zalma-esq-cfe-5vgkc.
“The Passover Seder For Americans”
For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lostthe ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah.
Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and ...
You Get What You Pay For – Less Coverage Means Lower Premium
Post number 5275
Posted on January 30, 2026 by Barry Zalma
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When Experts for Both Sides Agree That Two Causes Concur to Cause a Wall to Collapse Exclusion Applies
In Lido Hospitality, Inc. v. AIX Specialty Insurance Company, No. 1-24-1465, 2026 IL App (1st) 241465-U, Court of Appeals of Illinois (January 27, 2026) resolved the effect of an anti-concurrent cause exclusion to a loss with more than one cause.
Facts and Background
Lido Hospitality, Inc. operates the Lido Motel in Franklin Park, Illinois. In November 2020, a windstorm caused one of the motel’s brick veneer walls to collapse. At the time, Lido was insured under a policy issued by AIX Specialty Insurance Company which provided coverage for windstorm damage. However, the policy contained an exclusion for any loss or damage directly or indirectly resulting from ...
