Life Insurance Application Misrepresentation?

Life Insurance Application Misrepresentation?

What Is Material Misrepresentation In Life Insurance?

Is Your Life Insurance Denial Based on Life Insurance Material Misrepresentation?

Does your life insurance company say they won’t pay the life insurance policy benefits because of a Material “Misrepresentation” on your life insurance application? That means they are claiming that Misleading or Incorrect Information is on the policy application. Our life insurance lawyers can help you mount a defense for a life insurance material misrepresentation claim.

When a Misrepresentation on a Life Insurance Policy Application Is Discovered, What Actions May an Insurance Company Take?

Misrepresentations of material facts provide the insurer with a right to rescind the policy. This is the latest trend in life insurance companies avoiding paying life insurance policy benefits.

This is something the life insurance companies especially try to do on a policy that was first purchased less than two years before the unfortunate death of the loved one.  This is really something that is very harmful to families, a claims denial which causes additional worry and anxiety, after the passing of the family member.

What Is Material Misrepresentation In Life Insurance?

Material misrepresentation in life insurance means that the life insurance company claims that the life insurance application (Health History Questionnaire) contains false statements and/or intentional concealments of true facts of the insured party.

The life insurance company plays it like this: ask many health questions, making some of them very vague and open ended.  Ask a person about every minute medical detail of their family’s health history, for the last ten years.  Does anyone remember every single complaint made to a doctor over the last ten years, even if nothing came of it?  Shortness of breath? Headache? Chest pains?

A small incident reported to a doctor, without any major resulting diagnosis or recurring symptoms, can provide the false basis for the life insurance company to claim misrepresentation.

If your loved one died because of a sudden heart attack, the life insurance company will search all the medical records, looking for any reference to chest pain, tightness, or something else.  They will get all the medical records, from hundreds to even thousands of pages, searching for just this one forgotten reference.  (Surprising, when they were selling the policy, they never obtained any of the medical records, but now that they are called upon to live up to the policy, to provide the benefits, well, the full investigation begins).

A Los Angeles Times analysis of 2009 data found about two-thirds of disputed claims were for material misrepresentations, such as failure to disclose medical history details.

Insurers have denied claims and rescinded policies within the contestability period for reasons such as:

  • Lying about income
  • Not disclosing another life insurance policy
  • Incorrect or incomplete answers put on an application by an insurance agent
  • Failing to mention treatment for minor ailments
  • Lying about weight
  • Misrepresenting immigration status
  • Not mentioning smoking one cigarette a day.

This is a second challenge to you, the family.  Our clients shout with outrage that the life insurance companies do this investigation after the policy was paid for, just at the time you need the comfort of the benefits.  Yet, under California law, there is some basis, on policies that were issued less than two years before the death, if and only if there is a material misrepresentation on the application.

We are experienced and thorough in defending policies from allegations of “material misrepresentation.”  We work with an in-house medical expert to review and consider medical records.  That in-house medical record review saves clients thousands of dollars in initial costs, because we the resources to get that review done.  We work promptly and understand the importance of getting the benefits paid.  We know that your loved one did not have fraudulent intent or do anything to deceive the insurance company on the application, and that many of the questions are vague or unclear, and leaving off a long ago comment on a small ache or pain, that did not result in any great treatment or diagnosis, is perfectly understandable.

We don’t let the life insurance company manufacture some supposed misrepresentation, only to try to rescind the policy, and avoid paying just in your time of need.  We fight insurance companies every day, when they try to avoid paying benefits based on misrepresentation.  Email or call us today, now, so we can help you avoid misrepresentation, and get your life insurance lawyer now.

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