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Showing posts from July, 2022

Fraudulent Procurement Defense Looks More Like a 3105 Defense

  Compas Med., P.C. v Praetorian Ins. Co. , 2016 NY Slip Op 51000(U)(App. Term 2d Dept. 2016) “Moreover, defendant failed to establish as a matter of law that the misrepresentation by plaintiff’s assignor as to his place of residence was material ( see Interboro Ins. Co. v Fatmir , 89 AD3d 993  [2011]). For the foregoing reasons, the branches of defendant’s cross motion seeking summary judgment dismissing the first through third causes of action should have been denied.” The citing of Fatmir now opens up a new door regarding the evidence necessary to substantiate “material misrepresentations” in establishing a fraudulent procurement defense. “A misrepresentation is material if the insurer would not have issued the policy had it known the facts misrepresented ( see  Insurance Law § 3105 [b];  Novick v Middlesex Mut. Assur. Co. , 84 AD3d at 1330;  Varshavskaya v Metropolitan Life Ins. Co. , 68 AD3d at 856). “To establish materiality as a matter of law, the insurer  must present documenta

Georgia Law and New York law on material misrepresentations

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  JCC Med., P.C. v Infinity Group , 2016 NY Slip Op 26439 (App. Term 2d Dept. 2016) (1) It is uncontroverted that defendant had issued a Georgia automobile  insurance policy to the brother of plaintiff’s assignor, “effective from August 28, 2010 through August 28, 2011,” who had made various representations to defendant in his insurance application, including that he resided in Georgia, that the insured vehicle was garaged in Georgia, and that the assignor was an adult who resided in his Georgia household and also drove the insured vehicle. (2) “ Upon a review of the record, we find that defendant failed to show that there is a conflict between the laws of Georgia and New York with respect to the retroactive rescission of an automobile insurance policy which has been issued to a natural person for a private passenger vehicle, as both states prohibit the retroactive rescission of such a policy  ( see  Vehicle and Traffic Law § 313;  Matter of Government Empls. Ins. Co. v Nichols , 8 AD3

Quirky Workers Compensation case - WeSueThem

  “A motion for leave to renew “shall be based upon new facts not offered on the prior motion that would change the prior determination” (CPLR 2221 [e] [2]) and must “contain reasonable justification for the failure to present such facts on the prior motion” (CPLR 2221 [e] [3]).   We note that a claim for workers’ compensation benefits must be filed by the injured worker on a particular Board form within two years after the date of the accident (Workers’ Compensation Law § 28) and may not be assigned (Workers’ Compensation Law § 33).   Plaintiff did not demonstrate that its assignor had made a proper application for workers’ compensation benefits ( see A. B. Med. Servs., PLLC v American Tr. Ins. Co. , 34 Misc 3d 141 [A], 2012 NY Slip Op 50076[U] [App Term, 2d Dept, 9th & 10th Jud Dists 2012]).” Assume a decision comes out from the court stating that the EIP must make a prompt application to the board, the EIP does this and has the claim is denied due to failing to comply with WCL 2