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Misrepresentation: Insurance Company Efforts to Avoid Statutory Requirements

By Michael T. Sharkey

More than a century ago, many states began to protect policyholders from insurance company efforts to deny coverage on the grounds of alleged falsehoods in the application for insurance, when such alleged misstatements were not material to the insurance company's decision to sell the coverage. While insurance companies have attempted by various methods to avoid such protections, courts generally have rejected these efforts and upheld statutory limitations on an insurance company's right to void coverage.

Statements in an application for insurance can be considered either representations or warranties. See, e.g., Allstate Ins. Co. v. Boggs, 271 N.E.2d 855, 858 (Ohio 1971). If an allegedly incorrect statement is considered a representation, the insurance company must prove that it is material (or possibly that it was intentionally fraudulent) before it can succeed in a misrepresentation defense or rescission action based on the alleged misrepresentation. See, e.g., Lee R. Russ & Thomas F. Segalla, Couch on Insurance, '81:26 (3d ed. 2007). A statement is material if it affected the insurance company's decision to sell coverage or establish the premium. See, e.g., Mitchell v. United Nat'l Ins. Co., 25 Cal. Rptr. 3d 627, 638 (Ct. App. 2005). If, however, the statement is considered a warranty, the insurance company need only show that the statement was untrue. It need not show that the misstatement was material in order to succeed in defeating coverage. Couch '81:26.

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