When One Lies About an Insurance Claim He Will Never Prosper

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John Ruiz, proceeding pro se, sued Liberty Mutual Fire Insurance Company (“Liberty Mutual”), asserting that Liberty Mutual breached two homeowner’s insurance policies by failing to pay plaintiff’s water damage claims. Liberty Mutual asserts two counterclaims, seeking to recover money it paid to plaintiff pursuant to those policies and to investigate plaintiff’s claims. In John Ruiz v. Liberty Mutual Fire Insurance Company, No. 19 CV 4399 (VB), United States District Court, S.D. New York (February 14, 2022) the pro se plaintiff proved the old saw that he had an idiot for a client.

BACKGROUND

Liberty Mutual determined plaintiff violated the Concealment or Fraud Provision of the Policies and informed plaintiff it would not cover any of plaintiff’s claims relating to the Middletown Property. However, before denying plaintiff’s claims, Liberty Mutual had ultimately reimbursed plaintiff $43,943.76 in ALE related to the Arverne Property. Liberty Mutual would not have made those payments had Ruiz disclosed that Brooks-Ruiz was his wife.

DISCUSSION

A fact is material when it “might affect the outcome of the suit under the governing law.” It is the moving party’s burden to establish the absence of any genuine issue of material fact.

The Policies provide they are void if plaintiff “[i]ntentionally concealed or misrepresented any material fact or circumstance” or “[e]ngaged in fraudulent conduct.”

Liberty Mutual has demonstrated as a matter of law that plaintiff violated the Concealment or Fraud Provision. That is, it is undisputed plaintiff intentionally omitted his relationship with Brooks-Ruiz and misrepresented his connection to the Arverne Property.

Liberty Mutual offered conclusive evidence plaintiff misrepresented his connection to the Arverne Property. Liberty Mutual has shown it reasonably relied on plaintiff’s omissions and misrepresentations as a matter of law. 

Finally, it is undisputed Liberty Mutual was injured because of plaintiff’s conduct. As explained above, Liberty Mutual paid $43,943.76 in ALE it would not have covered had it known plaintiff and Brooks-Ruiz were married.

Judgment for Liberty.

ZALMA OPINION

An obvious and blatant fraud was attempted by Ruiz who lied blatantly to the adjuster, investigator and at an Examination Under Oath and took money he knew, or should have known, he was not entitled to obtain under the policy. Lies in the presentation of a claim where the insurer relied on the lie to its detriment, is fraud. The trial that follows should provide a judgment to Liberty for the money it paid, interest, and the costs of its investigation and the litigation as a result of the fraud. Simultaneously the prosecutor should consider criminal charges since insurance fraud is a felony.