State Farm Mut. Auto. Ins. Co. v Surgicore of Jersey City, LLC, 2021 NY Slip Op 03536 (1st Dept. 2021)
“The claim representative’s affidavit set forth the factual basis for plaintiff’s belief that the accident was not a covered event because the loss was intentionally caused and the injuries purportedly sustained by the claimants in connection with the June 1, 2018 accident therefore did not arise from an insured event. By failing to answer, the defaulting defendants are “deemed to have admitted” the allegations in the complaint, including that the accident was intentional and staged (Al Fayed v Barak, 39 AD3d 371, 372 [1st Dept 2007] [internal quotation marks omitted]). The claims representative’s affidavit, as well as red flags raised by defendant Walton’s testimony at her EUO, support plaintiff’s belief”
- Default = admit traversable issues
- Red flag = corroborative evidence
- Claims rep = outlining inconsistencies
I feel like we are getting close to defining “prima facie staged accident on MSJ.” I have zero love for staged accidents. And the thing is, the ones that get attention are the multiple Claimant accidents. I know why – it costs money to set it up so you want more “bang” for your buck. But this is where trouble always arises. Yet, if 1-50 get caught, them this case is just the price of doing business.