APPENDIX 4 COMPLAINT FOR INSURANCE FRAUD

• Jurisdiction: United States
• Publication year: 2018

The following is an example that can be used for an insurer suing an insured for insurance fraud.

COMES NOW Plaintiff, ABC Insurance Company by and through their attorneys, Redd, White and Blue, A Professional Corporation, and for cause of action alleges as follows:

COMMON ALLEGATIONS

Plaintiff, ABC Insurance Company ("ABC") that is a foreign insurer duly qualified to transact surplus lines insurance business in the State of ________.

Defendant, Abraham Lincoln Jones, individually and doing business as ALC, Inc, hereafter, "Jones" or "Defendant"), was at all times relevant hereto a resident of the County of ____, State of ______.

Jurisdiction is predicated upon the diversity of citizenship of the parties and that the matter in controversy, exclusive of interest and costs, exceeds the sum specified by 28 USC Section 1332.

Defendant JONES caused Plaintiff ABC to issue a policy of insurance to be performed in ____ County, ______, and the claim which has been submitted arises out of the storage of and alleged damage to a collection of antiques,(the "Property"), in _____ County, ______.

On or about August 18, 2008, Defendant JONES made application for insurance of property located in ___ _____, ______, for coverage in the sum of $500,000 on a location at 9770 Cheyenne Avenue; and $2 million on property located in the a warehouse, 6265 McLeod Drive, both situated in _________ County, ______.

The Defendant's application was submitted to ABC through an independent insurance broker called Antiques Insurance Services, LLC. ("Antiques").

Based upon the Defendant's application and ABC underwriting criteria Plaintiff ABC issued a policy of insurance to Defendant JONES, doing business as ALC, Inc., a sole corporation.

A true and correct copy of Policy No. ABC-HD 000011112222 which ABC issued to JONES on or about September 3, 20__, is attached hereto as Exhibit "1" and incorporated herein by reference.

Prior to the effective date of the policy an application for insurance was submitted by Defendant JONES that contained representations about the quality, value of the property the risk of loss of which he sought to insure, and other material facts upon which the ABC relied in making the decision to insure JONES.

On or about November 16, 2008, Defendant notified Plaintiff of a claim of total loss of the covered property at the Park 2000 location. It was alleged that some 500 antiques were stolen from the facility that Jones valued between five million dollars...