Misrepresentation Insurance | Everything You Need to Know About

An insurance company may deny coverage or cancel a policy if the customer has severe misrepresentations on the application for the procedure. Depending on the state, the carrier may or may not be necessary to prove that the misstatement was deliberate.

When you apply for insurance, it is your responsibility to provide all essential information and answer all questions honestly. Insurers may cancel your policy or deny coverage if you don’t comply with their requirements.

When a policyholder fails to disclose or fraudulently discloses material information that could jeopardize the insurer’s ability to estimate risk appropriately, someone can use “material misrepresentation.”

The insurance contract was void from the beginning of the policy was void. This is since the policyholder neglected to submit the information required by the insurer.

This procedure analyzes the risks associated with insuring them right from the start of the process. A serious misrepresentation claim may result in an insurer denying coverage even though the policy has a clean record.

So, carriers and insured’s alike need to look for misleading statements. Regardless of whether the misrepresentation was accidental or purposeful, insurance companies in Florida have the right to deny coverage and revoke the policy.

What Is Misrepresentation in Insurance?

Misrepresentation Insurance

When interacting with an insurance provider, various forms of misrepresentation are possible. By acting in bad faith, an insurer can suffer sue for the benefits you are entitled to if it misrepresents the terms of the policy you are buying or the claim you have made.

While your policy does cover your losses, they may deny coverage or make an unreasonably low settlement offer to deceive you into accepting less than your premiums should protect to avoid paying out the total value of your claim. Regardless, an adjuster’s bad faith misstatement should never go unpunished.

Misrepresentation is when one party makes a misleading statement about a substantial fact to sway the other party’s choice to engage in a contract with them. The parties may invalidate such an agreement, with the weaker party being compensated for losses. Everything is contingent upon the event’s conditions. The defendant is the one who is accused of making a false statement by another. The plaintiff is the party asserting a claim for damages.

Types of Misrepresentations

Misrepresentation Insurance

We can mention three types of Misrepresentations. Innocent misrepresentation is when the defendant gave a false statement of fact and was unaware that it was untrue when they signed the contract. Typically, a withdrawal or cancellation of the contract is the best course of action in this case.

The negligent misstatement is the second type. Defendant did not verify the assertion before signing a contract, which is a misrepresentation. We violate “reasonable care,” an obligation that a party must take on before entering a contract. Contract revocation and damages are possible remedies for negligent misrepresentation.

Fraudulent misrepresentation is a third category. There are two types of fraudulent misrepresentation: those made to deceive and those that are not. The damaged party has the right to declare the contract void and sue the defendant for damages.

Misrepresentations by agents and adjusters

Health insurance providers may examine your claim to establish whether or not you own the coverage and the proper amount of that coverage when you file a claim. In making their decision, they’ll take into account the specifics of your policy as well as the facts and circumstances surrounding your claim.

Insurers’ contracts are convoluted, replete with technical legalese and medical jargon. Legislators and insurance agents alike are well aware of this.

When the policy language is ambiguous or opaque, we rely on our insurance agents to help us understand the more complex components of the coverage. Prospective policyholders may be duped into signing a contract by an insurance agent who makes false representations about the policy’s proper coverage and benefits. The agent may misrepresent certain conditions, provisions, or requirements for coverage that don’t appear in the procedure.

It doesn’t matter if the agent did it intentionally or if they did it carelessly. It’s possible that, in the future, if you file a claim for coverage because of the agent’s misrepresentations, the business will deny your claim and cite the contract as evidence.

To be clear, insurance companies cannot refuse coverage because of an agent’s careless or willful misrepresentation of a policy’s coverage conditions, according to California law.

A claim for insurance bad faith may arise if an insurance agent pushes you into signing a policy and your insurer then refuses a claim that, had the assertions been genuine, would have been covered. You have a right to compensation. 

Other cases where you can find a Misrepresentation

After you’ve submitted your claim, you may be the victim of misrepresentation. Companies are always looking for ways to refuse or limit your coverage. 

Instead of risking a judicial battle, they might use that misinformation to get you to accept an unfair settlement offer right away. It is illegal for claims adjusters to misrepresent coverage, so don’t let them bully you about it.

How Misrepresentation Works

How Misrepresentation Works

Only statements of truth are subject to misrepresentation, not views or forecasts. Regardless of the size of the transaction, a misrepresentation can lead to a breach of contract.

The number of miles on an automobile might be misrepresented by the seller in a private transaction, leading to a purchase. Buying a car from a seller who misrepresents the vehicle’s condition can result in a lawsuit.

Deception in a high-stakes circumstance, such as a credit agreement, can interpret as an event of default by a lender. However, if a mergers and acquisitions (M&A) contract terminate due to a misrepresentation; a hefty break fee can impose.

Frequently Asked Questions

What is an example of misrepresentation in insurance?

It’s common for a misrepresentation to be either a deliberate or accidental falsehood. Swimming pool installation is an example of omitting information from the insurance company. They might have revoked the coverage if the carrier had not issued the insurance because of a substantial misstatement.

What are the types of misrepresentation in insurance?

Management liability insurance claims can result from three different kinds of misrepresentation: fraudulent, negligent, and innocent.

What is the effect of misrepresentation in insurance contracts?

Misrepresentation has the same effect on a contract as non-disclosure; it gives the offended party a reason to avoid the agreement.

When would a misrepresentation of the insurance be?

Even after you’ve filed your claim, someone else may make false statements to try to undermine your case. Companies are always looking for ways to refuse or limit your coverage. Claims adjusters may tell you things that are not true. For example, they may tell you that the policy does not cover covered damage.

What are some examples of misrepresentation?

Parties who know they’re inaccurate in fraudulent misrepresentation make false claims about a contract or transaction. Fraudulent misrepresentation, for example, occurs when a seller of a vehicle knows the vehicle has a transmission problem but represents the vehicle as being in perfect mechanical condition.

Bottom line

When we view all this, the insurer may refuse to defend the insured in a lawsuit. A lawsuit begins with a document known as a Statement of Claim, in which the plaintiff makes specific claims against the defendant.

If the insurance policy covers these allegations, the insurer must defend the defendant. In the case of lawyers, all of this proves the allegations true. The insured must pay all legal fees as a result of this.

However, the insurer may decline to defend its policyholder in court. This entire if the policyholder has made severe misrepresentations. There will be no insurance company to cover the costs of a claim from a policy holder’s liability.

Be honest with your insurance company and provide them with all pertinent information for these reasons.  If the insured makes a significant deception, any misstatement, whether innocent or malicious, will terminate an insurance contract.”

A significant misrepresentation happens when the carrier has not issued the policy, given a different policy. Maybe issued the same at an additional premium.


Adam Grabois is an expert in all aspects of Insurance and Property with 20 years of experience. He is a licensed broker of all lines including property, casualty, life, and health. As a licensed adjuster, he is well-versed in all aspects of insurance, and he owns All Needs Insurance agency in Florida.

He attended Tufts University where he earned his undergraduate degree, followed by a Master's degree from Columbia University.

Adam shares his breadth of experience by helping many businesses and individuals manage risk and protect themselves financially. He now shares this with the audience of the "Pro Insurance Info" website.

Articles: 281
error: Content is protected !!