Tag Archives: Misrepresentation

Jury Permitted to Determine if Misrepresentations by Insured Were Material

In many jurisdictions, for an insurer to carry its burden of proving that coverage is void due to a material misrepresentation, the insurer must prove not only that the misrepresented fact was something that the insurer wanted to know, but that the misrepresentation affected the insurer’s investigation. In other words, that the misrepresentation was material. … Continue Reading

Cell Phone Records Support Insurer’s Denial Based on Fraud

When insurers investigate insurance claims and suspect that something about the claim is not quite right, they often assign special investigation units evaluate whether the claim lacks merit or is otherwise fraudulent. In Young v. Progressive Casualty Insurance Company,1 a federal district court in California recently upheld an insurer’s denial of its insured’s claim for … Continue Reading

Insurers Cannot Rely on Rescission if They Fail to Inquire and Investigate Insureds Before Claims

After a claim is made, and despite the obligation to objectively, fairly, and reasonably investigate a claim with an eye toward providing coverage and without putting the insurance company’s interests ahead of their insured’s, some insurers actively look for ways to deny coverage. One of the ways some insurers do this is by using the … Continue Reading

Allstate Voids Policy and is Awarded Damages Due to Policyholder Misrepresentations

On November 22, 2016, Judge Berle M. Schiller from the District Court for the Eastern District of Pennsylvania issued his Opinion and Order in Payne v. Allstate Insurance Company, granting summary judgment to Allstate and awarding them $25,000 in damages, after finding that the Plaintiff made material misrepresentations while securing the homeowners policy.… Continue Reading

Insureds Recover Attorney Fees and Costs Despite Jury Finding of Misrepresentations or False Statements

A recent Florida case involved insureds whose home was insured by Citizens. On May 25, 2012, the home was damaged by water escaping from a broken plumbing system.1 Citizens’ adjuster inspected the home and noticed that the driveway and interior flooring had been trenched and the underground plumbing system had been removed by a plumbing … Continue Reading

Rescission Of Coverage When Misrepresentation In Policy Application Is Not Material To Acceptance Of Risk

Often, when a property insurance claim is reported (even one undisputedly covered) one of the first things many carriers will do is review the application for the policy to see if the insured answered questions either incorrectly or incompletely. This is because Section 627.409 of the Florida Statute allows insurers, in certain limited circumstances, to … Continue Reading

5 tips to make sure your insurance coverage is not voided.

Five tips to make sure your insurance coverage is not voided: When you are shopping for insurance coverage be sure to carefully read the underwriting section of the application. Don’t assume your insurance agent has filled out the correct information for personal questions, including your financial background and prior insurance. Don’t assume your insurance agent … Continue Reading

In North Carolina, the Insurer Can Waive Its Right to Claim Forfeiture

Insurance applications are important in the insurance marketplace. Applications are part of the risk analysis insurers make in determining whether they will issue a policy. There is exhaustive case law on issues of misrepresentations, ambiguities, and incomplete applications. The issue I want to discuss is whether an insurer can waive its right to deny a … Continue Reading

Universal Property Insurance Company’s Go-To Reason for Denying Claims May Come to an End

Last month, the Florida Senate Appropriations Committee unanimously passed Senate Bill 708. If the bill becomes law, part of the language would curb Universal Property Insurance Company, and all insurance companies in the state, from alleging certain application misrepresentations. Currently, Florida residential property insurance companies have 90 days to perform underwriting on an insurance risk … Continue Reading

Another Outrageous Insurance Claim Denial by People’s Trust Insurance Company, Part II

You don’t have to have a law degree or be an insurance guru to see through one of the recent arguments People’s Trust has been using when denying insurance claims. Buying insurance with People’s Trust is very different than the way insurance is purchased with other Florida carriers. The basic process is different because People’s Trust … Continue Reading

Insurance Policy Conditions (a/k/a/ Land Mines): Part 21 – “Intent” and the Fraud Condition

Most policies contain a “Concealment or Fraud” condition that reads along these lines: “With respect to all persons insured under this policy, we provide no coverage for loss if, whether before or after a loss, one or more persons insured under this policy have: a. Intentionally concealed or misrepresented any material fact or circumstance; b. … Continue Reading

New York Policyholders Prevail after Insurance Company Alleges Material Misrepresentation

Suffering a fire loss to your home can be devastating. I have listened to policyholders questioned in trial and deposition about these types of claims. Sometimes, insureds have lost everything but the clothes on their backs, and many times in cases of a total loss, the policyholders will describe the items that can’t be replaced- … Continue Reading