Zausmer attorney Michael Schwartz recently summary dismissal of two separate cases due to fraudulent and material misrepresentations offered in support of the plaintiffs’ claims.
In the first case, a health care provider sued for reimbursement of treatment rendered to a Home-Owners Insurance Company insured following an alleged motor vehicle accident. Michael’s investigation revealed that the insured submitted fraudulent proofs during his claim for insurance benefits; specifically, the insured overstated the number of days for which he was entitled to household services, asserted substantial wage loss despite the fact that his tax return showed his income increased after the accident and failed to disclose a previous medical history. Michael filed a motion for summary disposition, successfully arguing that because the insured’s claims were barred due to his fraud, the derivative claims of the medical provider were similarly barred.
In the second case, the plaintiff applied for auto insurance with Everest National Insurance in May 2015, indicating on the insurance application that she owned only one vehicle. In fact, she also owned a second vehicle but failed to disclose that on the application. A few months later, she was involved in an accident and filed a claim for first-party benefits under the policy. During discovery, the ownership of the other vehicle was uncovered. Everest then rescinded the policy because the second vehicle would have resulted in a substantial increase in premium charged for the policy. Michael filed a successful motion for summary disposition, arguing that Everest’s rescission of the policy was properly executed and that there was no binding coverage at the time of the accident. In a separate case brought by the passenger in the insured vehicle, Michael also prevailed on summary disposition, arguing that the rescission precluded the passenger’s claim under established case law.