Third Circuit Revives Consumer Fraud Act Class Action against Insurer Based on Adjuster’s Alleged Deceptive Conduct

The Third Circuit’s recent decision in Alpizar-Fallas v. Favero, __ F.3d __, 2018 WL 5987140 (3d Cir. Nov. 15, 2018), is a stark reminder that the process of adjusting an insurance claim is not exempt from the New Jersey Consumer Fraud Act, N.J.S.A. 56:8-1 et seq. (CFA). In Favero, Progressive Garden State Insurance Company (Progressive) insured, under two separate policies, the drivers of two vehicles involved in an accident. After the accident, a Progressive adjuster allegedly visited Ana Lidia Alpizar-Fallas (Plaintiff), one of …

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Insured Can’t Claim Damages in Proof of Loss Were “Puffed” Up to Avoid Federal Jurisdiction: Federal Court Deems Damages Demand in Sworn Proof of Loss Submitted to Insurer More Credible than Complaint’s Unsworn Estimate

On October 10, 2018, a Florida federal court ruled that an insured’s precise damages estimate, set out in an exhibit to his complaint against his insurer, of $73,963.19, was less credible than his pre-suit demand in his proof of loss form of $100,709.34.

The insured, Roger Ulloa, sued his insurer, Integon National Insurance Company, alleging it failed to fully pay his property damage claim in the wake of Hurricane Irma. Integon removed the case to federal court on the basis that Ulloa’s pre-suit estimate …

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