Grocer busted making fraudulent claim for undelivered meat
A month after the alleged robbery of 13 tons of meat, the grocery was set on fire during a second incident.
An insurer is not obligated to pay claims submitted by a meat retailer that suffered robbery, vandalism and fire due to suspicions of fraud from the insurer, according to a ruling from the U.S. Court of Appeals for the Sixth Circuit.
Meat Town, a grocer and butcher, filed claims with Sentinel Insurance Co., a Hartford unit, for losses that arose from a break-in, robbery and vandalism that occurred after-hours on November 10, 2015. During this incident, 13 tons of meat were allegedly stolen. A second incident occurred later, in December 2015, in which the premises were set on fire.
Meat Town never reopened for business after the initial vandalism event and was in the process of being evicted when the arsonist set fire to the building.
The store owner claimed over $485,000 in losses from the damages and almost $475,000 lost due to the fire.
Where’s the beef?
The insurer became suspicious that the claims were fraudulent and initiated an investigation into the claims, which revealed that they were fraudulent, leading to the denial of both.
The insurance policy in this case voids all coverage if the insured conceals or misrepresents material facts concerning its claim, e.g., commits fraud. Under Michigan law, to effectuate such a provision, the insurer must prove that the claim was (1) knowingly false or made in reckless disregard for the truth, and (2) material, such that the insured intended to induce the insurer to act upon it.
During the trial, Sentinel produced evidence showing that the vendors had not yet delivered the meat that was allegedly stolen by the vandals in the initial incident. Further, Meat Town failed to produce evidence to create a “genuine dispute of material fact” that the meat had not been delivered.
The court considered Sentinel more credible and construed the facts in favor of the insurer. The dissenting opinion stated that “a general issue of material fact remains about whether Meat Town’s misrepresentations were intentional and reckless.”
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