When a loved one passes away, families rely on life insurance benefits to cover funeral expenses, pay bills, and secure financial stability. Unfortunately, insurance companies often deny claims by alleging “material misrepresentation” on the policy application. In Florida, this defense is frequently raised—even years after the policy was issued. If your life insurance claim has been denied for alleged misrepresentation, you should know your rights and options.
What Is “Material Misrepresentation”?
A material misrepresentation occurs when the insurance company claims the insured gave false or incomplete information on their application that would have affected the insurer’s decision to issue coverage or set premiums. Common examples include:
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Failing to disclose a pre-existing medical condition.
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Omitting smoking, alcohol, or drug use.
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Inaccurately reporting income, employment, or lifestyle risks.
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Leaving out prior hospitalizations or treatments.
Insurance companies often use these claims to rescind policies or avoid paying valid benefits.
Florida Law on Misrepresentation in Life Insurance
Under Florida Statute § 627.409, a misrepresentation or omission can only void a policy if it is:
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Fraudulent, or
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Material to the insurer’s decision to provide coverage or determine the premium.
This means not every mistake or omission will justify denial. For example, forgetting to mention a minor past medical visit might not qualify as “material.” The insurer must prove that the misrepresentation directly affected its underwriting decision.
Contestability Period in Florida
Most life insurance policies include a two-year contestability period. During this time, the insurer can investigate and deny claims based on alleged misrepresentations, even if unintentional. After two years, insurers generally cannot rescind coverage for misstatements—unless fraud is proven.
What to Do If Your Claim Is Denied for Misrepresentation
If your claim is denied, don’t assume the insurance company is right. Steps to take include:
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Request a written denial letter – The insurer must explain the exact reason for denial.
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Review the application – Compare the alleged misrepresentation with the medical records and what was actually asked on the application.
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Gather documentation – Medical records, correspondence, and proof of premium payments can help show coverage should remain valid.
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Consult a Florida life insurance attorney – A lawyer can challenge whether the misrepresentation was truly material or fraudulent under Florida law.
How an Attorney Can Help
An experienced Florida life insurance lawyer can:
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Review whether the insurer’s denial complies with Florida statutes.
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Challenge the insurer’s interpretation of “material” misrepresentation.
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File suit if the denial was wrongful or in bad faith.
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Pursue damages, including attorney’s fees, in certain cases.
Conclusion
If your life insurance claim has been denied in Florida due to alleged “material misrepresentation,” you are not powerless. Florida law places limits on when and how insurers can rescind coverage. An attorney can help hold the insurance company accountable and fight for the benefits your family deserves.
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.
