Preview
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162
NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020
CI2020-15012 Index # : EF2020-0162
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162
NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020
Index #: EF2020-0162
Cl2020-15012
1600 Building, 424 Main Street, Buffalo, NY 14202
R U PP Liberty
716.854.3400 4 ruppbaase.com
BAASE
PFALZGRAF
CUNNINGHAM LLc MARCO CERCONE
EY S cercone@ruppbaase.com
A TT O R N
April 24, 2020
VIA CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Luciano L. Lama, Esq.
The Lama Law Firm, LLP
2343 North Triphammer Road
Ithaca, New York 14850
Dear Mr. Lama:
Re: Insured: Danielle Lavigne
Claim No.: 20I8-0044930
Date of Loss: May 13, 2018
Our FileNo.: 0005.2407
Enclosed please find New York Central Mutual Fire Insurance Company's
("NYCM") formal opinion and determination concerning your client's claim in the above-referenced
matter. Also enclosed are two checks in payment of your client's dwelling and personal property
claims in the amounts of $31,917.03 and $5,000, respectively. Kindly forward a copy of NYCM's
coverage letter to your client.
Sincerely,
Marco Cercone
Enclosures
cc: Peter J. Walsh, Esq. (via electronic mail only, with copy of enclosures)
Rochester Williamsville Albany Jamestown
| |
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162
NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020
Index #: EF2020-0162
Ci2020-15012 . ,
n INSURA
m NCE
New
1899
York Central
Central
800-234-6926
Plaza
Mutual
East,
Fire Insurance
Edmeston, NY
Company
13335-1899
nycm.com
April 1, 2020
Danielle LaVigne
1278 Ridge Road
Lansing, New York 14882
Dear Ms. LaVigne:
Re: Insured: Danielle LaVigne
Claim No.: 2018-0044930
Policy No.: 4655265
Date of Loss: May 13, 2018
Loss Location: 25 Sperry Lane. Lansing. New York 14882
New York Central Mutual Fire insurance Company ("NYCM") has completed its investigation into
the above-referenced claim. The following will constitute NYCM's formal opinion and
determination for your claim.
The above-referenced claim under policy.number 4655265 (the "Policy") is for property damage to
the property located at 25 Sperry Lane, Lansing, New York 14882 ("insured premises"). The fire
loss at the insured premises occurred on or about May 13, 2018. You have submitted a claim
under dwelling and personal property contained in the above-referenced policy. Based on NYCM's
investigation, it will afford coverage for a portion of your dwelling claim and your personal
property claim. However, NYCM must deny a portion of your claim for dwelling for which you
sought coverage totaling $470,000.00. Further, NYCM is willing to make payment for that portion
of your personal property claim that is substantiated. All sworn proofs of loss we have received in
connection with this claim are rejected as to the value stated.
In New York, a party not named as an insured or an additional insured on the face of a policy is
not entitled to coverage. Moleon v. Kreisler Borg Florman General Construction Company, Inc.,
304 A.D.2d 337 (1st Dep't 2003); see also Counihan v. Allstate Insurance Company, 142 F.R.D. 387,
388 (E.D.N.Y. 1992). Thus, only those named on the policy hold an insurable interest in the
covered by the policy of insurance. The terms of an insurance polic determine the extent
property
of covera e afforded to those who hold an insurable interest. See Stainless, nc. v. Employers Fire
Ins. Co., 9 A.D.2d 27, 31 (1st Dep't 1979) aff'd49 N.Y.2d 924 (1980). Under policy #4655265,
Danielle LaVigne is the sole listed insured. Therefore, you are the only person who holds an
insurable interest in the insured premises and the sole individual who is entitled to coverage
under the aforementioned of insurance. We refer you to the following provisions contained
policy
in your policy of insurance.
NYC HO 7 04 17 - PREMlER PROTECTION POLICY
SECTION I - CONDITIONS
A. Insurable Interest And Limit Of Liability .
Even if more than one person has an insurable
interest in the property covered, we will not be liable
in any one loss:
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162
NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020
C12020-15012 Index #: EF2020-0162
"insured"
1. To an for more than the amount of
"insured's"
such interest at the time of loss; or
2. For more than the applicable limit of liability.
NYCM's investigation revealed the construction of the insured premises primarily was
f-inanced your father, Andrew LaVigne. Specifically, he handled the finances of the
by
construction and expended $437,389.27 to construct the home located at 25 Sperry Lane,
Lansing, New York. These expenses include various payments to JBM Construction, 84
Lumber, contractor Peter Brown, JD's Lawn Maintenance, Parrot Plumbing, Sweazey's AC &
Heating, Reeves Brothers, and Vitale & Robinson. Andrew LaVigne is not a named insured
on the Policy, and therefore is not entitled to coverage for the above-referenced fire loss.
Therefore, NYCM must deny this portion of your claim as Andrew LaVigne has no interest
under the policy of insurance at issue in this claim.
Notwithstanding, NYCM will afford partial coverage for your dwelling claim. Based on the
above-referenced policy provisions and applicable New York law, NYCM will afford coverage
for the amount you have proven to have personally expended in designing, permitting, and
constructing the insured premises. NYCM's investigation revealed that you expended a total
of $31,917.03 during the planning and construction process. Specifically, you expended
$2,745.50 on permits for the construction of the insured premises, $8,679.70 for building
supplies, $14,912.30 for interior materials, and $5,579.53 for architecture and design. This is
based on the documentation obtained by NYCM in its investigation of your claim and your
sworn testimony. This number represents the claim offer for the above-
dwelling
referenced claim. As you indicated in your sworn testimony during your examination under
oath, you are not seeking to be reimbursed for monies not expended by you personally in the
construction of the insured premises. Therefore, a check will be issued to you in the amount of
$31,917.03 under separate cover for the portion of your claim that has been substantiated.
Regarding your claim for personal property, you submitted a sworn proof of loss claiming
$24,465.00 in damages. Notably, this calculation does not account for depreciation. NYCM's
investigation of your claim revealed that, although the insured premises were not fully
constructed, some of your personal property was stored at the insured premises. In support of your
claim, you submitted documentation evidencing various personal property claimed to be lost in
conjunction with the fire loss and provided some supporting receipts. Based on NYCM's review of
the evidence and your sworn testimony, much of your personal property claim is unsubstantiated.
Be that as itmay, and in the spirit of compromise, NYCM is willing to offer you $5,000.00 in a full
and final settlement of your personal property claim. NYCM acknowledges that, notwithstanding
the strength of its position, settling this matter at thisjuncture may be a benefit to all parties,
especially considering the abundance of legal issues surrounding this claim. Please advise us of
your position in response to this letter with regard to NYCM's offer on your personal property
claim.
Based on the forgoing, NYCM affords coverage for portions of your dwelling and personal property
claims resulting from the May 13, 2018 fire loss as outlined above. For clarification purposes,
NYCM will issue a check for $31,917.03 in regards to your dwelling claim, and is willing to issue a
check for $5,000.00 in regards to your personal property claim, should you be willing to accept its
offer on your claimfor personal property.
Finally, should you pursue this matter further, please be advised that NYCM reserves the right to
defend itself on other policy provisions, including, but not limited to, the following:
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162
NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020
CI2020-15012 Index #: EF2020-0162
"insured"
1. To an for more than the amount of
"insured's"
such interest at the time of loss; or
2. For more than the applicable limit of fiability.
NYCM's investigation revealed the construction of the insured premises primarily was
financed your father, Andrew LaVigne. Specifically, he handled the finances of the
by
construction and expended $437,389.27 to construct the home located at 25 Sperry Lane,
Lansing, New York. These expenses include various payments to JBM Construction, 84
Lumber, contractor Peter Brown, JD's Lawn Maintenance, Parrot Plumbing, Sweazey's AC &
Heating, Reeves Brothers, and Vitale & Robinson. Andrew Lavigne is not a named insured
on the Policy, and therefore is not entitled to coverage for the above-referenced fire loss.
Therefore, NYCM must deny this portion of your claim as Andrew LaVigne has no interest
under the policy of insurance at issue in this claim.
Notwithstanding, NYCM will afford partial coverage for your dwelling claim. Based on the
above-referenced policy provisions and applicable New York law, NYCM will afford coverage
for the amount you have proven to have personally expended in designing, permitting, and
constructing the insured premises. NYCM's investigation revealed that you expended a total
of $31,917.03 during the planning and construction process. Specifically, you expended
$2,745.50 on permits for the construction of the insured premises, $8,679.70 for building
supplies, $14,912.30 for interior materials, and $5,579.53 for architecture and design. This is
based on the documentation obtained by NYCM in its investigation of your claim and your
sworn testimony. This number represents the claim offer for the above-
dwelling
referenced claim. As you indicated in your sworn testimony during your examination under
oath, you are not seeking to be reimbursed for monies not expended by you personally in the
construction of the insured premises. Therefore, a check will be issued to you in the amount of
$31,917.03 under separate cover for the portion of your clai.m that has been substantiated.
Regarding your claim for personal property, you submitted a sworn proof of loss claiming
$24,465.00 in damages. Notably, this calculation does not account for depreciation. NYCM's
investigation of your claim revealed that, although the insured premises were not fully
constructed, some of your personal property was stored at the insured premisesc In support of your
claim, you submitted documentation evidencing various personal property claimed to be lost in
conjunction with the fire loss and provided some supporting receipts. Based on NYCM's review of
the evidence and your sworn testimony, much of your personal property claim is unsubstantiated.
Be that as it may, and in the spirit of compromise, NYCM is willing to offer you $5,000.00 in a full
and final settlement of your personal property claim. NYCM acknowledges that, notwithstanding
the strength of its position, settling this matter at thisjuncture may be a benefit to all parties, .
especially considering the abundance of legal issues surrounding this claim. Please advise us of
your position in response to this letter with regard to NYCM's offer on your personal property
claim.
Based on the forgoing, NYCM affords coverage for portions of your dwelling and personal property
claims resulting from the May 13, 2018 fire loss as outlined above. For clarification purposes,
NYCM will issue a check for $31,917.03 in regards to your dwelling claim, and is willing to issue a
check for $5,000.00 in regards to your personal property claim, should you be willing to accept its
offer or1your claim for personal property.
Finally, should you pursue this matter further, please be advised that NYCM reserves the right to
defend itself on other policy provisions, including, but not limited to, the following:
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162
NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020
C12020-15012 - Index #: EF2020-0162
New York Central Mutual Fire Insurance Company
1899 Central Plaza East, Edmeston, NY 13335-1899
a 800-234-6926 nycm.com
SECTION I - EXCLUSIONS
!
A. We do not insure for loss caused directly or
indirectly by any of the following. Such loss is
excluded regardless of any other cause or event
contributing concurrently or in any sequence to the
loss. These exclusions apply whether or not the loss
event results in widespread damage or affects a
substantial area.
8. Intentional Loss
Intentional Loss means any loss arising out of
"insured"
any act an commits or conspires to
commit with the intent to cause a loss.
"insured"
This exclusion only applies to an who
commits or conspires to commit an act with the
intent to cause a loss.
* * * * *
SECTIONS I AND II - CONDITIONS
H. Concealment Or Fraud
"insured"
We do not provide coverage for the who,
whether before or after a loss, has:
1. Intentionally concealed or misrepresented any
material fact or circumstance; or
2. Engaged in fraudulent conduct;
relating to this insurance.
Furthermore, Regulation 95, Section 86.4(a) issued by the Insurance Department of the State of
New York states that:
Any person who knowingly and with intent to defraud any insurance
company or other person files an application for insurance or statement
of claim containing any materially false information, or conceals for the
purpose of misleading, information concerning any fact material
thereto, commits a fraudulent insurance act, which is a crime and shall
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162
NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020
Cl2020-15012 .
Index #: EF2020-0162
, , . .
also be subject to a civil penalty not to exceed five thousand dollars and
the stated value of the claim for each such violation.
NYCM reserves all of itsrights and defenses with respect to your claim and itwill not waive its
rights or defenses under any circumstances. New York insurance regulations require us to advise
you that in the event you wish to contest this denial in litigation, the policy requires you to
commence such action within two years of the inception of loss. Additionally, should you wish to
take this matter up with the New York State Insurance Department, you may file with the
Department either on its website at: www.ins.state.ny.us/complhow.htm or you may write to or
visit the Consumer Services Bureau, New York State Insurance Department at: One State Street,
New York, NY 10004; One Commerce Plaza, Albany, NY 12257; 1339 Franklin Ave, Garden City,
NY 11530 or Walter J. Mahoney Office Building, 65 Court Street, Buffalo, NY 14202.
Sincerely,
Jacalyn A Wise
Property Examiner III
cc: Marco Cercone, Esq
(via email only)
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162
NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020
C12020-15012 Index #: EF2020-0162
also be subject to a civil not to excead five thousand dollars and
penalty
the stated value of the claim for each such violation. c
NYCM reserves all of its rights and defenses with respect to your claim and itwill not waive its
rights or defenses under any circumstances. New York insurance regulations require us to advise
you that in the event you wish to contest this denial in litigation, the policy requires you to
commence such action within two years of the inception of loss. Additionally, should you wish to
take this matter up with the New York State Insurance Department, you may file with the
Department either on i.tswebsite at: www.ins.state.ny.us/complhow.htm or you may write to or
visit the Consumer Services Bureau, New York State Insurance Department at: One State Street,
New York, NY 10004; One Commerce Plaza, Albany, NY 12257; 1339 Franklin Ave, Garden City,
NY 11530 or Walter J. Mahoney Office Building, 65 Court Street, Buffalo, NY 14202.
Sincerely,
Jacalyn A Wise
Property Examiner III
cc: Marco Cercone, Esq
(via email only)
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162
NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020
Cl2020-15012
Index #: EF2020-0162
New York Central Mutual
7 . 3 8. 07
Agent: 00392 2Z
CHECK SENT TO: INSURED
LARKIN AGENCY INC
401 NORTH AURORA ST
BOX 698 r
ITHACA NY 14850
IN PAYMENT OF:
FIRE
Claimant- 000 DESK#:
JWISE
MP: 40 LC: 007
Policy#: 4655265 Branch 0
Claim Number: 2018 -004493
* * * * * * * * * * * * * * * * * * * * *
Number of Attached Check: 0037984 72
* Aber-de=ed Property Laws *
* * Amount of Attached Check: $31, 917 . 03
require us to surrender checks not
4. cashed to your state government... * Date: 04/01/2020
* PLEASE CASHPROMPTLY *
*********************
BANK OF AMERICA . . .. . . . . .
Fire Instiránce Company
. 1899 Cential
PlaziEan
Claim No. 2018-004493-0 Date: 04/01/2020
******31, 917*DOLLARS .AND**03**CENT È PAÝ ONLY $314 917.O
PAY TO THE ORDER OF VALID 6 MONTHS ONLY
CFU ISAOA AND
CFU ISAOA
AND
DANIELLE LAVIGNE
25 SPERRY LN
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162
NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020
Index#:EF2020-0162
Cl2020-15012
New Ÿork Central Mutual
7.36.18
Agent: 0039 2 2 Z
CHECK SENT TO: INSURED
LARKIN AGENCY INC
401 NORTH AURORA ST
BOX . 698
ITHACA NY 14850
IN PAYMENT OF: .
FIRE
Claimant- 000 DESK#:
JWISE
MP: 40 LC: 007
Policy#: 4655265 . Branch O
Claim Number: 2018-004493
* ** * * ** ** * * * * * * * * * * * *
Number of Attached Check: 003798471
* Abar.dõñedPropertyLaws *
* Amount of Attached Check: $5, 000. 00
require us to surrender checks not *
* cashed to your state government... * Date: 04/01/2020
* PLEASECASHPROMPTLY *
* * * * * * * * * * * * *·* * * * * * * *
- -
BANKOFAMERICA .
. . . . Fire inst rmee . ..
Company
. 1.899CentralPlazaEast
ClaimNo.2018 - 004493-0 - Date; 04f01/2020
*******5, 000*DOLLARS AND**00**CENTS - . 15At ONEY $5, 000. 00
PAY TO THE ORDER OF VA .ID 6.MONTHS ONLÝ
DANIELLE LAVIGNE .
25 SPERRY LN .. ..
Preview
FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020 CI2020-15012 Index # : EF2020-0162 FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020 Index #: EF2020-0162 Cl2020-15012 1600 Building, 424 Main Street, Buffalo, NY 14202 R U PP Liberty 716.854.3400 4 ruppbaase.com BAASE PFALZGRAF CUNNINGHAM LLc MARCO CERCONE EY S cercone@ruppbaase.com A TT O R N April 24, 2020 VIA CERTIFIED MAIL RETURN RECEIPT REQUESTED Luciano L. Lama, Esq. The Lama Law Firm, LLP 2343 North Triphammer Road Ithaca, New York 14850 Dear Mr. Lama: Re: Insured: Danielle Lavigne Claim No.: 20I8-0044930 Date of Loss: May 13, 2018 Our FileNo.: 0005.2407 Enclosed please find New York Central Mutual Fire Insurance Company's ("NYCM") formal opinion and determination concerning your client's claim in the above-referenced matter. Also enclosed are two checks in payment of your client's dwelling and personal property claims in the amounts of $31,917.03 and $5,000, respectively. Kindly forward a copy of NYCM's coverage letter to your client. Sincerely, Marco Cercone Enclosures cc: Peter J. Walsh, Esq. (via electronic mail only, with copy of enclosures) Rochester Williamsville Albany Jamestown | | FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020 Index #: EF2020-0162 Ci2020-15012 . , n INSURA m NCE New 1899 York Central Central 800-234-6926 Plaza Mutual East, Fire Insurance Edmeston, NY Company 13335-1899 nycm.com April 1, 2020 Danielle LaVigne 1278 Ridge Road Lansing, New York 14882 Dear Ms. LaVigne: Re: Insured: Danielle LaVigne Claim No.: 2018-0044930 Policy No.: 4655265 Date of Loss: May 13, 2018 Loss Location: 25 Sperry Lane. Lansing. New York 14882 New York Central Mutual Fire insurance Company ("NYCM") has completed its investigation into the above-referenced claim. The following will constitute NYCM's formal opinion and determination for your claim. The above-referenced claim under policy.number 4655265 (the "Policy") is for property damage to the property located at 25 Sperry Lane, Lansing, New York 14882 ("insured premises"). The fire loss at the insured premises occurred on or about May 13, 2018. You have submitted a claim under dwelling and personal property contained in the above-referenced policy. Based on NYCM's investigation, it will afford coverage for a portion of your dwelling claim and your personal property claim. However, NYCM must deny a portion of your claim for dwelling for which you sought coverage totaling $470,000.00. Further, NYCM is willing to make payment for that portion of your personal property claim that is substantiated. All sworn proofs of loss we have received in connection with this claim are rejected as to the value stated. In New York, a party not named as an insured or an additional insured on the face of a policy is not entitled to coverage. Moleon v. Kreisler Borg Florman General Construction Company, Inc., 304 A.D.2d 337 (1st Dep't 2003); see also Counihan v. Allstate Insurance Company, 142 F.R.D. 387, 388 (E.D.N.Y. 1992). Thus, only those named on the policy hold an insurable interest in the covered by the policy of insurance. The terms of an insurance polic determine the extent property of covera e afforded to those who hold an insurable interest. See Stainless, nc. v. Employers Fire Ins. Co., 9 A.D.2d 27, 31 (1st Dep't 1979) aff'd49 N.Y.2d 924 (1980). Under policy #4655265, Danielle LaVigne is the sole listed insured. Therefore, you are the only person who holds an insurable interest in the insured premises and the sole individual who is entitled to coverage under the aforementioned of insurance. We refer you to the following provisions contained policy in your policy of insurance. NYC HO 7 04 17 - PREMlER PROTECTION POLICY SECTION I - CONDITIONS A. Insurable Interest And Limit Of Liability . Even if more than one person has an insurable interest in the property covered, we will not be liable in any one loss: FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020 C12020-15012 Index #: EF2020-0162 "insured" 1. To an for more than the amount of "insured's" such interest at the time of loss; or 2. For more than the applicable limit of liability. NYCM's investigation revealed the construction of the insured premises primarily was f-inanced your father, Andrew LaVigne. Specifically, he handled the finances of the by construction and expended $437,389.27 to construct the home located at 25 Sperry Lane, Lansing, New York. These expenses include various payments to JBM Construction, 84 Lumber, contractor Peter Brown, JD's Lawn Maintenance, Parrot Plumbing, Sweazey's AC & Heating, Reeves Brothers, and Vitale & Robinson. Andrew LaVigne is not a named insured on the Policy, and therefore is not entitled to coverage for the above-referenced fire loss. Therefore, NYCM must deny this portion of your claim as Andrew LaVigne has no interest under the policy of insurance at issue in this claim. Notwithstanding, NYCM will afford partial coverage for your dwelling claim. Based on the above-referenced policy provisions and applicable New York law, NYCM will afford coverage for the amount you have proven to have personally expended in designing, permitting, and constructing the insured premises. NYCM's investigation revealed that you expended a total of $31,917.03 during the planning and construction process. Specifically, you expended $2,745.50 on permits for the construction of the insured premises, $8,679.70 for building supplies, $14,912.30 for interior materials, and $5,579.53 for architecture and design. This is based on the documentation obtained by NYCM in its investigation of your claim and your sworn testimony. This number represents the claim offer for the above- dwelling referenced claim. As you indicated in your sworn testimony during your examination under oath, you are not seeking to be reimbursed for monies not expended by you personally in the construction of the insured premises. Therefore, a check will be issued to you in the amount of $31,917.03 under separate cover for the portion of your claim that has been substantiated. Regarding your claim for personal property, you submitted a sworn proof of loss claiming $24,465.00 in damages. Notably, this calculation does not account for depreciation. NYCM's investigation of your claim revealed that, although the insured premises were not fully constructed, some of your personal property was stored at the insured premises. In support of your claim, you submitted documentation evidencing various personal property claimed to be lost in conjunction with the fire loss and provided some supporting receipts. Based on NYCM's review of the evidence and your sworn testimony, much of your personal property claim is unsubstantiated. Be that as itmay, and in the spirit of compromise, NYCM is willing to offer you $5,000.00 in a full and final settlement of your personal property claim. NYCM acknowledges that, notwithstanding the strength of its position, settling this matter at thisjuncture may be a benefit to all parties, especially considering the abundance of legal issues surrounding this claim. Please advise us of your position in response to this letter with regard to NYCM's offer on your personal property claim. Based on the forgoing, NYCM affords coverage for portions of your dwelling and personal property claims resulting from the May 13, 2018 fire loss as outlined above. For clarification purposes, NYCM will issue a check for $31,917.03 in regards to your dwelling claim, and is willing to issue a check for $5,000.00 in regards to your personal property claim, should you be willing to accept its offer on your claimfor personal property. Finally, should you pursue this matter further, please be advised that NYCM reserves the right to defend itself on other policy provisions, including, but not limited to, the following: FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020 CI2020-15012 Index #: EF2020-0162 "insured" 1. To an for more than the amount of "insured's" such interest at the time of loss; or 2. For more than the applicable limit of fiability. NYCM's investigation revealed the construction of the insured premises primarily was financed your father, Andrew LaVigne. Specifically, he handled the finances of the by construction and expended $437,389.27 to construct the home located at 25 Sperry Lane, Lansing, New York. These expenses include various payments to JBM Construction, 84 Lumber, contractor Peter Brown, JD's Lawn Maintenance, Parrot Plumbing, Sweazey's AC & Heating, Reeves Brothers, and Vitale & Robinson. Andrew Lavigne is not a named insured on the Policy, and therefore is not entitled to coverage for the above-referenced fire loss. Therefore, NYCM must deny this portion of your claim as Andrew LaVigne has no interest under the policy of insurance at issue in this claim. Notwithstanding, NYCM will afford partial coverage for your dwelling claim. Based on the above-referenced policy provisions and applicable New York law, NYCM will afford coverage for the amount you have proven to have personally expended in designing, permitting, and constructing the insured premises. NYCM's investigation revealed that you expended a total of $31,917.03 during the planning and construction process. Specifically, you expended $2,745.50 on permits for the construction of the insured premises, $8,679.70 for building supplies, $14,912.30 for interior materials, and $5,579.53 for architecture and design. This is based on the documentation obtained by NYCM in its investigation of your claim and your sworn testimony. This number represents the claim offer for the above- dwelling referenced claim. As you indicated in your sworn testimony during your examination under oath, you are not seeking to be reimbursed for monies not expended by you personally in the construction of the insured premises. Therefore, a check will be issued to you in the amount of $31,917.03 under separate cover for the portion of your clai.m that has been substantiated. Regarding your claim for personal property, you submitted a sworn proof of loss claiming $24,465.00 in damages. Notably, this calculation does not account for depreciation. NYCM's investigation of your claim revealed that, although the insured premises were not fully constructed, some of your personal property was stored at the insured premisesc In support of your claim, you submitted documentation evidencing various personal property claimed to be lost in conjunction with the fire loss and provided some supporting receipts. Based on NYCM's review of the evidence and your sworn testimony, much of your personal property claim is unsubstantiated. Be that as it may, and in the spirit of compromise, NYCM is willing to offer you $5,000.00 in a full and final settlement of your personal property claim. NYCM acknowledges that, notwithstanding the strength of its position, settling this matter at thisjuncture may be a benefit to all parties, . especially considering the abundance of legal issues surrounding this claim. Please advise us of your position in response to this letter with regard to NYCM's offer on your personal property claim. Based on the forgoing, NYCM affords coverage for portions of your dwelling and personal property claims resulting from the May 13, 2018 fire loss as outlined above. For clarification purposes, NYCM will issue a check for $31,917.03 in regards to your dwelling claim, and is willing to issue a check for $5,000.00 in regards to your personal property claim, should you be willing to accept its offer or1your claim for personal property. Finally, should you pursue this matter further, please be advised that NYCM reserves the right to defend itself on other policy provisions, including, but not limited to, the following: FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020 C12020-15012 - Index #: EF2020-0162 New York Central Mutual Fire Insurance Company 1899 Central Plaza East, Edmeston, NY 13335-1899 a 800-234-6926 nycm.com SECTION I - EXCLUSIONS ! A. We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event contributing concurrently or in any sequence to the loss. These exclusions apply whether or not the loss event results in widespread damage or affects a substantial area. 8. Intentional Loss Intentional Loss means any loss arising out of "insured" any act an commits or conspires to commit with the intent to cause a loss. "insured" This exclusion only applies to an who commits or conspires to commit an act with the intent to cause a loss. * * * * * SECTIONS I AND II - CONDITIONS H. Concealment Or Fraud "insured" We do not provide coverage for the who, whether before or after a loss, has: 1. Intentionally concealed or misrepresented any material fact or circumstance; or 2. Engaged in fraudulent conduct; relating to this insurance. Furthermore, Regulation 95, Section 86.4(a) issued by the Insurance Department of the State of New York states that: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and shall FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020 Cl2020-15012 . Index #: EF2020-0162 , , . . also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. NYCM reserves all of itsrights and defenses with respect to your claim and itwill not waive its rights or defenses under any circumstances. New York insurance regulations require us to advise you that in the event you wish to contest this denial in litigation, the policy requires you to commence such action within two years of the inception of loss. Additionally, should you wish to take this matter up with the New York State Insurance Department, you may file with the Department either on its website at: www.ins.state.ny.us/complhow.htm or you may write to or visit the Consumer Services Bureau, New York State Insurance Department at: One State Street, New York, NY 10004; One Commerce Plaza, Albany, NY 12257; 1339 Franklin Ave, Garden City, NY 11530 or Walter J. Mahoney Office Building, 65 Court Street, Buffalo, NY 14202. Sincerely, Jacalyn A Wise Property Examiner III cc: Marco Cercone, Esq (via email only) FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020 C12020-15012 Index #: EF2020-0162 also be subject to a civil not to excead five thousand dollars and penalty the stated value of the claim for each such violation. c NYCM reserves all of its rights and defenses with respect to your claim and itwill not waive its rights or defenses under any circumstances. New York insurance regulations require us to advise you that in the event you wish to contest this denial in litigation, the policy requires you to commence such action within two years of the inception of loss. Additionally, should you wish to take this matter up with the New York State Insurance Department, you may file with the Department either on i.tswebsite at: www.ins.state.ny.us/complhow.htm or you may write to or visit the Consumer Services Bureau, New York State Insurance Department at: One State Street, New York, NY 10004; One Commerce Plaza, Albany, NY 12257; 1339 Franklin Ave, Garden City, NY 11530 or Walter J. Mahoney Office Building, 65 Court Street, Buffalo, NY 14202. Sincerely, Jacalyn A Wise Property Examiner III cc: Marco Cercone, Esq (via email only) FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020 Cl2020-15012 Index #: EF2020-0162 New York Central Mutual 7 . 3 8. 07 Agent: 00392 2Z CHECK SENT TO: INSURED LARKIN AGENCY INC 401 NORTH AURORA ST BOX 698 r ITHACA NY 14850 IN PAYMENT OF: FIRE Claimant- 000 DESK#: JWISE MP: 40 LC: 007 Policy#: 4655265 Branch 0 Claim Number: 2018 -004493 * * * * * * * * * * * * * * * * * * * * * Number of Attached Check: 0037984 72 * Aber-de=ed Property Laws * * * Amount of Attached Check: $31, 917 . 03 require us to surrender checks not 4. cashed to your state government... * Date: 04/01/2020 * PLEASE CASHPROMPTLY * ********************* BANK OF AMERICA . . .. . . . . . Fire Instiránce Company . 1899 Cential PlaziEan Claim No. 2018-004493-0 Date: 04/01/2020 ******31, 917*DOLLARS .AND**03**CENT È PAÝ ONLY $314 917.O PAY TO THE ORDER OF VALID 6 MONTHS ONLY CFU ISAOA AND CFU ISAOA AND DANIELLE LAVIGNE 25 SPERRY LN FILED: TOMPKINS COUNTY CLERK 10/21/2020 05:04 PM INDEX NO. EF2020-0162 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 10/21/2020 Index#:EF2020-0162 Cl2020-15012 New Ÿork Central Mutual 7.36.18 Agent: 0039 2 2 Z CHECK SENT TO: INSURED LARKIN AGENCY INC 401 NORTH AURORA ST BOX . 698 ITHACA NY 14850 IN PAYMENT OF: . FIRE Claimant- 000 DESK#: JWISE MP: 40 LC: 007 Policy#: 4655265 . Branch O Claim Number: 2018-004493 * ** * * ** ** * * * * * * * * * * * * Number of Attached Check: 003798471 * Abar.dõñedPropertyLaws * * Amount of Attached Check: $5, 000. 00 require us to surrender checks not * * cashed to your state government... * Date: 04/01/2020 * PLEASECASHPROMPTLY * * * * * * * * * * * * * *·* * * * * * * * - - BANKOFAMERICA . . . . . Fire inst rmee . .. Company . 1.899CentralPlazaEast ClaimNo.2018 - 004493-0 - Date; 04f01/2020 *******5, 000*DOLLARS AND**00**CENTS - . 15At ONEY $5, 000. 00 PAY TO THE ORDER OF VA .ID 6.MONTHS ONLÝ DANIELLE LAVIGNE . 25 SPERRY LN .. ..