Deliberately lying on a life insurance application is the surest way to have a claim for benefits under the policy eventually denied. An applicant for life insurance who fails to disclose a health condition or who intentionally misrepresents his or her alcohol or tobacco usage is setting up his or her beneficiaries for a potential denial of life insurance benefits. When a claim for benefits is presented to the insurer by the named beneficiary during the contestability period of the policy, the life insurance company will investigate potential grounds to deny the claim on the basis of a misrepresentation. When the life insurance company can demonstrate that the misrepresentation is material to the issuance of the life insurance policy (i.e., that the insurance company would not have issued the policy or would have done so only for a higher premium or with other modified terms), the carrier might be relieved from its obligation to pay the policy’s benefit to the beneficiary.
The beneficiary in Sanders et al. v. Life Insurance Co. of North America discovered that where an insurance carrier might attempt to draw this line can be complicated and surprising.
The ‘Misrepresentation’ at Issue in Sanders
Henry Sanders purchased a supplemental life insurance policy through his employer. That policy was issued by the defendant insurance company, Life Insurance Co. of North America. On the life insurance application, Mr. Sanders allegedly listed his height as five feet, eleven inches. However, an autopsy conducted on Mr. Sanders following his death listed his height as only five feet, ten and one-half inches tall. Using the deceased medical reports, the insurance company claimed Mr. Sanders’ actual height was several inches shorter yet – between five feet, eight inches and five feet, nine inches. Based on this discrepancy in height, the insurance company allegedly claimed that the underwriter would not have approved Mr. Sanders’ application.
The life insurance company dened the claim despite medical evidence suggesting that a person’s height can vary throughout their lifetime and can even vary up to one-half of an inch in a single day.
You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].
