Misrepresentations Made After Loss But Before An Examination Under Oath

New Jersey Merlin Law Group attorney Jason Cieri was married last week. It was a fantastic wedding. It also provided me a chance to catch-up with some Jersey Shore public adjusters, discuss the upcoming PPAANJ seminar on November 14 and write this blog which includes a case discussion involving post loss misrepresentations made prior to an examination under oath.

Jesse Sipe and I talked about various legislative matters facing New Jersey public adjusters and what the PPAANJ can do about them. This also includes a better dialogue with the new Insurance Commissioner in New Jersey. These matters and how New Jersey public adjusters can help in making these concerns a reality will be discussed in much greater detail at the November 14 meeting.

A recent New Jersey case discussed two insurance coverage practice pointers.¹ Incorrect answers to an insurer’s questions can be made following a loss. Insureds should try to correct these as soon as possible. The incorrect answers also must be “material” to the insurance company’s claim. The insurance company has the burden to prove the materiality.

Although our conclusion as to the absence of anything in Pokhan’s evidence to establish the materiality of her admittedly willful misstatements to State Farm is dispositive of the appeal, we agree with plaintiff that a fact-finder could also consider whether Pokhan corrected her misstatements promptly in her examination under oath in considering their materiality. See Mariani v. Bender, 85 N.J. Super. 490, 501 (App. Div. 1964) (holding ‘[e]ven though an insured may have given his insurance carrier an untrue statement of the accident, no breach of the cooperation clause results if the untrue statement is promptly and seasonably corrected’).²

Do not hesitate to contact a Merlin Law Group attorney if you have a claim denial because of an alleged incorrect answer to an insurer’s post-loss investigation.

So, a big congratulations and good luck to Jason Cieri on his marriage. A big Cheers! from me to all my New Jersey friends and I look forward to seeing you again soon, and certainly at the November 14 meeting in Red Bank.

Thought For The Day

Surround yourself with good people. People who are going to be honest with you and look out for your best interests.
—Derek Jeter
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¹ Pokhan v. State Farm Fire and Cas. Co., No. A-3336-17T3, 2019 WL 3425917 (N.J. App. July 30, 2019).
² Id.