When a Florida life insurance company denies a claim, one of the most common reasons is “material misrepresentation.” This refers to false, incomplete, or misleading information provided on the life insurance application—usually relating to medical history, income, lifestyle, or other risk factors.
Under Florida law, a misrepresentation is material if it would have affected the insurer’s decision to issue the policy or the premium charged. In other words, if the truth would have changed the underwriting decision, the insurer may use it to deny the claim.
But insurers often misuse this rule, denying legitimate claims over minor or irrelevant discrepancies. Beneficiaries should understand what counts—and what doesn’t.
Examples of Alleged Material Misrepresentations in Florida
Insurance companies frequently claim material misrepresentation for issues such as:
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Undisclosed medical conditions (diabetes, heart disease, mental health treatment)
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Inaccurate height or weight
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Failure to list smoking or vaping history
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Omitting prescription medications
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Under-reporting alcohol or drug use
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Misstating income or employment status
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Incorrect answers about prior hospitalizations, surgeries, or treatments
However, not every mistake on an application is material, and insurers must prove the misrepresentation was significant enough to affect coverage.
Florida Law Protects Policyholders and Beneficiaries
Florida Statute § 627.409 governs misrepresentations in insurance applications. To deny benefits, an insurer must show that the misrepresentation:
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Was material to the risk,
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Induced the insurer to issue the policy, or
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Increased the insurer’s hazard of loss.
Importantly:
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Small errors (like incorrect dates) usually are not material.
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If the insurer’s own agent filled out the application incorrectly, Florida law may limit the insurer’s ability to deny the claim.
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If the insurer could have discovered the truth through reasonable underwriting, they may not be able to rely on the misrepresentation defense.
How the Contestability Period Affects Misrepresentation Claims
Most Florida life insurance policies include a two-year contestability period. During this time, insurers can review the application and deny claims for misrepresentation—even if unrelated to the cause of death.
After two years:
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The policy becomes incontestable,
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The insurer generally cannot deny the claim for material misrepresentation,
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Except for proven fraud.
Understanding whether the policy was in effect for more than two years is one of the first steps in analyzing a denial.
Common Problems With Misrepresentation Denials
Life insurance companies often get it wrong. Beneficiaries should be on the lookout for:
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Denials based on medical records the insurer never verified during underwriting
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Allegations based on trivial or irrelevant information
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Insurer relying on vague or overly broad application questions
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Insurer using the cause of death to justify retroactive underwriting
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Errors made by agents, brokers, or tele-application systems
A skilled Florida life insurance attorney can often challenge these issues and recover benefits.
What Beneficiaries Should Do After a Misrepresentation-Based Denial
If you receive a denial letter citing “material misrepresentation,” take the following steps:
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Request a complete copy of the policy and the original application.
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Review the insurer’s specific allegations—many denial letters are vague or misleading.
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Obtain the underwriting file, including notes and guidelines used when the policy was issued.
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Gather relevant medical records to show the alleged misrepresentation was not material.
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Speak with an attorney experienced in Florida life insurance disputes.
Many beneficiaries win misrepresentation disputes once an attorney forces the insurer to prove its allegations.
When to Contact a Florida Life Insurance Claims Attorney
If an insurer is accusing your loved one of providing false or misleading information, you do not have to accept the denial. An experienced attorney can:
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Analyze whether the alleged misrepresentation was actually material
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Challenge improper or unlawful underwriting practices
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Negotiate or litigate the claim
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Pursue interest, attorney’s fees, and penalties when available
Florida law gives beneficiaries powerful protections—your attorney can help you use them.
Final Thoughts
“Material misrepresentation” is one of the most common ways Florida life insurance companies deny claims, but many denials are legally improper. Beneficiaries should not take the insurer’s word for it. With the right evidence and legal support, you may be able to overturn the denial and recover the full policy benefits.
Have you or someone you know been denied a life insurance claim? Contact Florida Life 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 Miami Attorney Gonzalez-Sirgo directly at jp@yourattorneys.com or by text at (305) 929-8935.
