Allstate Ins. Co. v. Lopez

738 A.2d 987, 325 N.J. Super. 268, 1999 N.J. Super. LEXIS 319
CourtNew Jersey Superior Court Appellate Division
DecidedJune 11, 1999
StatusPublished
Cited by6 cases

This text of 738 A.2d 987 (Allstate Ins. Co. v. Lopez) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allstate Ins. Co. v. Lopez, 738 A.2d 987, 325 N.J. Super. 268, 1999 N.J. Super. LEXIS 319 (N.J. Ct. App. 1999).

Opinion

738 A.2d 987 (1999)
325 N.J. Super. 268

ALLSTATE INSURANCE COMPANY, Plaintiff,
v.
Idabells LOPEZ, et al., Defendants.

Superior Court of New Jersey, Law Division, Morris County.

Decided June 11, 1999.

*988 James Sullivan, Morristown, for plaintiff (Sullivan & Graber, attorneys).

Steven Stadtmauer, West Orange, for defendant Hackensack University Medical Center (Celentano, Stadtmauer & Walentowicz, attorneys, Clifton).

V. Maria Christiano, for defendants Henry Opalka (deceased) and Stella Opalka (Norton, Arbert, Sheehy & Higgins, attorneys).[1]

VILLANUEVA, J.A.D. (retired and temporarily assigned on recall).

Allstate Insurance Company ("Allstate") brings this declaratory judgment action against a myriad of 434 "insureds" and medical providers for alleged insurance fraud pursuant to the New Jersey Insurance Fraud Prevention Act ("the Fraud Act"), N.J.S.A. 17:33A-1 to -14. Previously, this court has stayed hundreds of personal injury lawsuits and arbitrations for personal injury protection ("PIP") benefits.[2]

Allstate now moves for partial summary judgment to have this court (1) declare that the insurance policy issued to "Siber Rodriguez" be declared void ab initio and that no third party has derived any rights from such policy because it was fraudulently obtained by an imposter, and further (2) dismiss all claims brought by any person using the name "Eric Dominguez" or his assignee and all claims brought by individuals owning, driving or occupying any motor vehicle owned, driven or occupied by a person using the name "Eric Dominguez" or his or her assignee.[3]

The first issue is whether a third party can acquire any rights against an insurer, either as a purported "insured" under the policy or as an assignee, after an imposter ["Siber Rodriguez"] obtained an insurance policy.

The second issue is whether an insurer has any liability for claims arising out of an impostor's ["Eric Dominguez's"] actions in staging accidents, including claims either by injured persons who were parties to a fraudulent scheme to defraud insurance companies or by their assignees.

I.

ALLSTATE'S ALLEGATIONS

This case is only one of numerous cases involving one of the largest automobileaccident fraud rings documented in United States history.[4] This fraud ring operates primarily in the cities of Passaic and Paterson, New Jersey ("Passaic-Paterson fraud ring"). The participants in this ring instituted hundreds of personal injury law *989 suits and arbitration proceedings seeking PIP and other benefits. These actions were brought either individually or through medical provider assignees.

For the most part, the participants design each accident to appear as if it were caused solely by the negligence of a single insured driver. Hence, ring members consistently employ predictable factual scenarios that serve as a blueprint in order to ensure that the at-fault participant is easily recognizable and the participants avoid actual injury. These scenarios include: low-speed rear-end hits, intersection accidents caused by a driver's acknowledged failure to obey a stop sign, impacts caused by a driver's failure to yield when exiting from a parking lot, driveway or parking space, and, side-swipes of a stopped vehicle caused by another driver's wide turn. These fact patterns generally foreclose liability questions and are designed to encourage insurance companies to settle claims quickly without litigation.

"Siber Rodriguez" and Orlando Figueroa were allegedly insured by Allstate. Maximo Medina, Justo Moreno, Jose Rojas, Luis Igo, Sonia Pabon, Idabells Lopez and Andy Catanichi were, in fact, insured by Allstate and had almost identical insurance policies. Their policies have $100,000/$300,000 uninsured motorist coverage. These policies cover insured vehicles at least fifteen years old. None of these policies included comprehensive theft/collision coverage. That coverage option would subject the insured's vehicles to a photo-inspection which would document any pre-existing damage. The policies also provide the minimum permitted by law for PIP medical deductible expenses. These policies are similar to the policies purchased by other known members of the Passaic-Paterson fraud ring, such as "Siber Rodriguez" and Orlando Figueroa (a/k/a Jose Nazario).

II.

UNDISPUTED MATERIAL FACTS REGARDING "SIBER RODRIGUEZ"[5]

Allstate policy number XXXXXXXXX was issued to "Siber Rodriguez" on December 28, 1995. During the application process, Allstate agents collected copies of a driver's license issued to "Siber Rodriguez," a certificate of title and motor vehicle registration for a 1980 black Chevrolet station wagon registered to "Siber Rodriguez," and a rent receipt for "Siber Rodriguez" indicating his address as 446 Monroe Avenue, Passaic.

The application was signed by "Siber Rodriguez," who listed his social security number as XXX-XX-XXXX and his date of birth as September 21, 1959. However, the name "Siber Rodriguez" is an appropriated identity. The real Siber Rodriguez confirmed that he had never obtained an Allstate insurance policy and that his social security number was XXX-XX-XXXX and his date of birth was September 21, 1959.

Jose Nazario (also known as Orlando Figueroa) is believed to be a major ringleader in the Passaic-Paterson fraud ring and is being investigated for his involvement in at least twenty-six alleged accidents in a fourteen-month period. Orlando Figueroa also appears to be a false persona created to defraud insurance companies.

It was later discovered that the person or persons purporting to be "Siber Rodriguez": (1) was involved in accidents with other ring players; and/or (2) lent a car to another ring member who subsequently caused an automobile accident; and/or (3) borrowed a car from another ring player and operated that vehicle during an automobile accident; and/or (4) was connected through relationships with passengers in *990 separate accidents. Every person who owned, drove, or occupied a vehicle in which "Siber Rodriguez" was the purported owner, driver, or a passenger, was a member of the Passaic-Paterson fraud ring. No defendant has disputed these allegations by competent evidence. See R. 4:46-5(a) and R. 1:6-6.

The name "Siber Rodriguez" was used by various ring members to submit claims for injuries allegedly arising out of staged or intentionally caused accidents on eleven separate dates between November 14, 1995 and October 24, 1996. This, in turn, generated fourteen claims for bodily injury and PIP benefits submitted to Allstate.

Many of the claimants provided the same address as "Siber Rodriguez" when filing their respective claims. This address is known as a center for ring-related activity. Between December 16, 1992 and April 14, 1997, various ring members filed at least 136 claims with different insurers; all claimants provided 446 Monroe Avenue, Passaic as his or her home address.

III.

"In order to justify cancellation or rescission of [an insurance] policy for a misrepresentation material to the risk, it must appear that in issuing the policy the carrier relied upon the misrepresentation and that the circumstances were such that its reliance thereon was reasonable." Allstate Ins. Co. v. Meloni, 98 N.J.Super. 154, 160, 236 A.2d 402 (App.Div.1967).

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Bluebook (online)
738 A.2d 987, 325 N.J. Super. 268, 1999 N.J. Super. LEXIS 319, Counsel Stack Legal Research, https://law.counselstack.com/opinion/allstate-ins-co-v-lopez-njsuperctappdiv-1999.