Contract Breaches that Allow Multiple Different Grounds to Make a Policy Void
More from Excellence in Claims Handling Substack for Subscribers Only. You can Subscribe to my substack at https://barryzalma.substack.com/subscribe
Posted on February 24, 2026 by Barry Zalma
You’re reading from the free part of Excellence in Claims Handling until you reach the paywall. 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 “subscribe” link below.
If an insured breaches one or more material warranties and increases the risk covered by the policy, the contract may be voided by the insurer, depending on the jurisdiction. It is, therefore, essential that every claims investigation include efforts to establish compliance with every warranty.
In Cummings v. Fire Insurance Exchange, 292 Cal. App. 3d 1407, 249 Cal. Rptr. 568 (1988), the Court of Appeal found a policy to be void when the insured filed a false property insurance claim. Ms. Cummings claimed that her home had been vandalized by unknown persons in her absence. In fact, the home had been damaged by Ms. Cummings’ son in her presence during an argument. Ms. Cummings lied because she was afraid of her son and the damage he might do to her in addition to the damage he had already done to her house. Although the court empathized with Ms. Cummings’ family problems the empathy did not overcome the need to truthfully report claims. When Ms. Cummings confessed to her lie, her claim was defeated and the policy made false. The Cummings court made it clear that lying to an insurer causes a policy to be void.
Defrauding an insurer is a civil wrong that allows an insurer to declare a policy void. It is also a crime in most states. If the crime is established the claim must be void because the state proved the fraud beyond a reasonable doubt, a much more stringent requirement than the insurer’s need to prove the fraud beyond a preponderance of the evidence.
Adapted from my book, Zalma on Insurance Claims, Part 104 Available as a paperback and Available as a Kindle Book
BARRY ZALMA:
The author: Barry Zalma, Esq., CFE, Consultant, Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847. 310-390-4455, [email protected], http://www.zalma.com, http://zalma.com/blog
(c) 2026 Barry Zalma & ClaimSchool, Inc.
Please tell your friends and colleagues about this substack so they can subscribe. 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 the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/, https://gettr.com/@zalma
Fraud Perpetrators Have no Honor
Post number 5294
See the video at and at and at https://zalma.com/blog plus more than 5250 posts.
First Circuit Affirms Sentence
In United States Of America v. Chang Goo Yoon, No. 24-1520, United States Court of Appeals, First Circuit (February 20, 2026) Chang Goo Yoon, a licensed physical therapist operating clinics in Massachusetts, engaged in a fraudulent scheme between November 2014 and November 2018. He submitted over a million dollars in false health insurance claims to private insurers, including Blue Cross Blue Shield and Aetna, as well as personal injury claims to MAPFRE, his own car insurer.
Facts
Yoon fabricated treatment notes, billed for services never rendered, and used his office address as patients’ addresses to ensure reimbursement checks were sent directly to him. This arrangement prevented patients from receiving paperwork for services they did not...
Fraud Perpetrators Have no Honor
Post number 5294
See the video at and at and at https://zalma.com/blog plus more than 5250 posts.
First Circuit Affirms Sentence
In United States Of America v. Chang Goo Yoon, No. 24-1520, United States Court of Appeals, First Circuit (February 20, 2026) Chang Goo Yoon, a licensed physical therapist operating clinics in Massachusetts, engaged in a fraudulent scheme between November 2014 and November 2018. He submitted over a million dollars in false health insurance claims to private insurers, including Blue Cross Blue Shield and Aetna, as well as personal injury claims to MAPFRE, his own car insurer.
Facts
Yoon fabricated treatment notes, billed for services never rendered, and used his office address as patients’ addresses to ensure reimbursement checks were sent directly to him. This arrangement prevented patients from receiving paperwork for services they did not...
Bad Faith Suit Requires Specificity About What Was Unfair
Pro Se Plaintiff Needed a Lawyer
Post number 5292
See the video at https://lnkd.in/gEZFNq38 and at https://lnkd.in/gZXMPDRb, and at https://zalma.com/blog plus more than 5250.
In Sean Shurelds v. SAFECO Insurance Company of America, a/k/a Liberty Mutual, Civil Action No. 25-cv-1550, United States District Court, E.D. Pennsylvania (February 11, 2026) Plaintiff Sean Shurelds, acting pro se, filed suit against Safeco Insurance Company of America alleging bad faith insurance practices, fraudulent misrepresentation, and negligence with the USDC giving him several attempts to sufficiently allege facts to state a cause against SAFECO.
Shurelds had purchased a landlord protection policy for his Philadelphia property, which was in effect from November 28, 2023, to November 28, 2024. After his tenant abandoned the property and unauthorized occupants caused extensive damage, Shurelds submitted five insurance claims to Safeco. Safeco denied all of these claims, citing the ...
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
See the video at and at
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 ...
