Our attorneys represent policyholders whose claims have been denied for a variety of reasons, including misrepresentations on a life insurance application. A policyholder has a duty to provide accurate information to the insurer. If the application contains a material misrepresentation, the insurer may deny your claim.
However, just because an insurance company claims a material misrepresentation was made does not make it so. In many cases, an insurance company’s denial is wrong.
A material misrepresentation is the purposeful or unintentional concealment of a relevant fact. The most common misrepresentation issue that arises in life insurance cases concerns the disclosure of health information. For a variety of reasons, the fact that a medical condition was not disclosed on an application does not immediately give the insurer the right to deny the claim. Sometimes an applicant may not disclose a minor medical ailment. Other times an applicant may not be aware of a diagnosed condition. Further, the application itself may have not been fully completed by the applicant or the agent. It is also not uncommon for the insurance company to already have the information that it claims the applicant did not disclose.
In short, insurance companies often claim an applicant made a material misrepresentation when the opposite is true.
State law requires life insurance policies to contain a clause that state the policy will be incontestable after it has been in force during the lifetime of the insured for two years from its date, except for nonpayment of premiums. Despite these legal protections, insurance companies will still deny valid claims.
Speaking with an Attorney
You should consult an attorney if you believe your life insurance claim was wrongfully denied. In many cases an alleged misrepresentation is not material, in which case, the insurer is liable under the policy.