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Insurance Claim – Coverage

By: Derek Hawkins//June 23, 2020//

Insurance Claim – Coverage

By: Derek Hawkins//June 23, 2020//

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WI Court of Appeals – District II

Case Name: Kemper Independence Insurance Company v. Ismet Islami

Case No.: 2019AP488

Officials: Reilly, P.J., Gundrum and Davis, JJ.

Focus: Insurance Claim – Coverage

Ismet Islami (Ismet) appeals a summary judgment order in favor of Kemper Insurance Company (Kemper) denying coverage for loss of her home stemming from a fire intentionally set by Ydbi Islami (Ydbi), from whom Ismet is legally separated. The trial court ruled that coverage to Ismet was barred under a “concealment or fraud” condition of her policy, which provides that “no” insured has coverage if “an” insured, whether before or after the loss, conceals or misrepresents any fact upon which the insurer relies or which contributes to the loss.

The above policy provision is in play because Ydbi, in addition to setting the fire, lied about his misdeeds in sworn post-loss statements to Kemper. Ismet, who indisputably had nothing to do with the arson or Ydbi’s false denial, seeks to avoid what would otherwise be the coverage-defeating consequences of Ydbi’s lies, on three grounds. These are: (1) WIS. STAT. § 631.95 (2017-18) prevents denial of coverage to a domestic abuse victim based on acts of the abuser that cause, or instill fear of causing, physical harm to the victim; (2) because of their legal separation, Ydbi is not Ismet’s “spouse,” and therefore is not an “insured” to whom the “concealment or fraud” provision applies; (3) the policy is “several,” so under the principles articulated in Hedtcke v. Sentry Insurance Co., 109 Wis. 2d 461, 326 N.W.2d 727 (1982), Ydbi’s violation of the “concealment or fraud” condition cannot be imputed to an “innocent insured” such as Ismet. The trial court rejected these arguments and granted summary judgment in favor of Kemper. We affirm.

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Derek A Hawkins is trademark corporate counsel for Harley-Davidson. Hawkins oversees the prosecution and maintenance of the Harley-Davidson’s international trademark portfolio in emerging markets.

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