Category: Intentional Loss

The loss was not intentional

Matter of Progressive Advanced Ins. Co. (Widdecombe), 2018 NY Slip Op 00061 (3d Dept. 2018) (1) “Initially, it is undisputed, as Supreme Court correctly determined, that Germain is an uninsured motorist as none of his automobile policies, including a prior policy with Hartford, was in effect on the date of this incident. Thus, any exclusion in […]

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A staged accident raises an issue of fact

Easy Care Acupuncture, PC v Hartford Ins. Co., 2017 NY Slip Op 51470(U)(App. Term 1st Dept. 2017) This first party, no-fault action is not susceptible to summary disposition. The evidentiary proof submitted by defendant-insurer in support of its motion for summary judgment, while sufficient to demonstrate that defendant had a “founded belief” that the assignor’s injuries […]

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From the eyes of the insured has its limits

Nationwide Gen. Ins. Co. v Pontoon, 2014 NY Slip Op 09001 (2d Dept. 2014) “The referee incorrectly concluded that GEICO was required to submit evidence that Pontoon was involved in staging the collision in order to support a disclaimer of coverage. Contrary to the referee’s conclusion, if GEICO can prove that the collision was staged by […]

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Verdict sustaining that the loss was intentional sustained

V.S. Med. Servs., P.C. v State Farm Mut. Ins. Co., 2014 NY Slip Op 50615(U)(App. Term 2d Dept. 2014) “Prior to trial, the parties stipulated that the sole question for the jury’s determination was whether the motor vehicle collision at issue was the result of an intentionally caused event. An investigator from defendant’s Special Investigation Unit […]

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Successful summary judgment: Plaintiff Assignor jumped on a parked car and walked away and the complaint was dismissed

New York Hosp. Med. Ctr. of Queens v Utica Mut. Ins. Co., 2012 NY Slip Op 52388(U)(App. Term 2d Dept. 2012) In this case, the Plaintiff Assignor jumped on a parked car and walked away and the complaint was dismissed “In support of its cross motion, defendant submitted an affidavit by its insured who stated […]

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Staged accident and non-payments of premiums

21st Century Advantage Ins. Co. v Cabral Look, 21st Century did their homework.  Someone admitted to defrauding the insurance companies.  Yet, Mr. All Boro, a distant relative of of Mr. Five Boro felt the need to put in gratuitous opposition to the preliminary injunction motion.  As such, more paper and judicial resources were were wasted […]

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An intentional act is precluded if not raised in a timely denial

Nyack Hosp. v Allstate Ins. Co.,  2011 NY Slip Op 04644 (2d Dept. 2011) This Medicaid crisis has spurred judicial activism from the Appellate Division, Second Department.  Now an intentional act, both a coverage issue and a policy exclusion has been deemed to be the latter, to the exclusion of the former. I swear people […]

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