Florida Health Insurance Definitions

Florida Health Insurance Terms:
"Material Misrepresentation"

Define: "Material Misrepresentation":

A statement made by an applicant or proposed insured in the policy's application which is not factually correct. If the truth had been disclosed, the insurance company would not have issued the policy, would have issued it differently, or would have issued it with limited benefits or a higher premium.

More Examples of Material Misrepresentation:

The intentional concealment, distortion or fabrication of a material fact. Also - concealment, contribute-to-the-loss statute, election to avoid a policy, fraud, material fact, representation, warranty.

The policyholder/applicant makes a false statement of any material (important) fact on his/her application. For instance, the policyholder provides false information regarding the location where the vehicle is garaged.

The material misrepresentation defense is a tactic that has long been used by insurance companies to defeat claims. Although carriers use the term "material misrepresentation defense," lawyers for policyholders sometimes refer to it as "post-claims underwriting." This defense involves a comprehensive attempt by insurance carriers to review every square inch of an application for insurance, hoping to identify an item in the application that was left out or completed incorrectly. If the carrier discovers even a minor error in the application, it may attempt to void all coverage based on that "misrepresentation," and deny all claims submitted.

Further details - Material Misrepresentation: MORE FACTS


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