Success Not Element of Insurance Fraud in New Jersey

New Jersey, January 20.  The New Jersey Supreme Court has unanimously  ruled that the state insurance fraud statue does not require the perpetrator to be successful in  the effort to sustain a conviction.   In State v. Goodwin, A-20 September Term 2014, 07352 (pdf copy attached below), Justice Albin wrote for a 6-0 majority that the making of a statement of a material fact  to an insurer “that has the capacity to influence a decision-maker in determining whether to cover a claim” was sufficient proof to sustain a conviction under N.J.S.A. 2C:21-4.6(a).

Justice Albin wrote:

If the falsehood is discovered during an investigation but before payment of the claim, a defendant is not relieved of criminal responsibility.  Here, defendant falsely reported that his girlfriend’s vehicle was stolen.  It was for the jury to determine whether the series of false statements about the theft generated by the defendant had the capacity to influence the insurance carrier in deciding whether to reimburse for the damage caused by the arson.

Goodwin, at pp. 2-3.    The Supreme Court reversed a N.J. Superior Court ruling which overturned the conviction on grounds that the jury instructions permitted conviction without showing harm or prejudice to the insurer, Progressive.

Justice Albin found that the State’s argument that “material fact” required an element of actual prejudice to it was far too strict an interpretation of the statute.  He referred to prior state and federal criminal statutes on perjury and false statement to rule that actual harm has never been a prerequisite to a conviction for crimes of falsehood.

Finally, the Court ruled that the Model Jury Charge on insurance fraud accurately set forth the standard for conviction and that the jury was free to conclude that Goodwin’s knowingly false statements affected Progressive’s analysis of whether to pay the claim.

State v. Goodwin, N.J. Supreme Court, 2016

 

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Philly Trial Court Recommends Dismissal of Time-Barred Bad Faith Claim

In an opinion  recommending that summary judgment in favor of the insurer be affirmed pursuant to Pa.R.A.P. 1925, , the Philadelphia Court of Common Pleas has ruled that the plaintiff failed to file his bad faith claim within two years of his claims denial, time-barring the claim under the two year statute of limitations.

In Fieldhouse v. Metropolitan Property Ins. Co., 2015 Phila. Ct. Com. Pl. LEXIS 396, the Court found that the Plaintiff’s bad faith claim, premised upon the insurer’s cooperation with law enforcement in their investigation of the auto accident which gave rise to the claim, was filed more than two years after the claim was denied.

Fieldhouse v. Metropolitan Property Ins. Co., 2015 Phila. Ct. Com. Pl. LEXIS 396

Editor’s Note: The statute of limitations defense  aside, it is highly unlikely any Court would find that an insurer’s cooperation with law enforcement in the investigation of an auto accident would constitute bad faith under the Pa. Bad Faith Statute, 42 Pa. C.S. A. §8371.