How Companies Use Misrepresentation as a Defense?
The insurance company might deny individual’s claim in different ways. One of the best and most commonly employed is to defend themselves against a legal defense known as “misrepresentation.” The defense of misrepresentation comes out of Florida Statutes, which enables insurance carriers to cancel their insurance cover if they have the opportunity to establish a fault in a risk-covered insurance application. The point here is that “material” is the deception. If the insurance provider can establish that a different premium would be paid if the real facts were disclosed in the application, a substantial deception exists.
When is Material Misrepresentation Unintentional?
Unfortunately, when the defense of significant misrepresentation is offered, the courts do not take intent into account. The majority of the time, this defense is used to protect the innocent customers who make a mistake on their application. Typically, the applicant completed their insurance application with little to no assistance from the insurance company. The questions they answered were either difficult or subject to interpretation, and they did not answer them in the manner that the insurance company desired. Nonetheless, they were compelled by law to respond to the insurance company’s assessment of their rate unaffected. This dilemma is exacerbated by the fact that the insurance company is under no need to investigate the applicant’s response. Still, they do have the right to check the responses at any time. Unfortunately, this means that they usually do not investigate until it is advantageous to them to do so. The bottom line is that ignorance is bliss for insurance companies. The law allows them to accept individual’s coverage with little to no examination into one’s qualifications, then terminate it at any time if those answers do not conform to what they want. As a result, when it comes time to file a claim under their insurance coverage, most insured are severely disadvantaged.
Recent Judgment
This idea was recently clarified in the case of Karl Wallace v Amtrust Insurance Company of Kansas, Inc. Wallace’s father resided in an apartment on 1100 Lone Oak Drive in Oakhurst, Texas, just a few hundred miles from Fort Worth, until he died in 2007. On this property, there was a mobile home as well as 130 acres of land. Because he was allocated a life estate at the site, Robert Günther continued living in the mobile home until he died in 2009. After that, Wallace, a Fort Worth resident, purchased the property on his own in late 2009. John Cole Insurance Agency, Inc insured the Wallace Father property. The corporation of Cole has no power on behalf of AmTrust to sell or bind coverage. Wallace maintains that he said that it was unoccupied and uninhabited. No trouble occurred until a grass fire destroyed the mobile home on the building. The court then revoked the policy, which was later renewed. AmTrust began researching the claim of Wallace. Wallace finally sued the Texas Insurance Code for infringements, breach of contracts, and violations of DTPA. In reply, Amtrust and Cole filed summary judgment motions which were granted and followed by this appeal. AmTrust indicated that it identified erroneous representations under oath during the Wallace examination, and AmTrust was not obliged to pay Wallace per the policy. In the appeal, the court upheld Wallace’s argument.
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