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Multiple Claims Denied Due To An Alleged Material Misrepresentation In Application For Insurance

Multiple Claims Denied Due To An Alleged Material Misrepresentation In Application For Insurance

A client recently retained the Law Offices of Felipe E. Diez, P.A. to represent him in multiple claims for insurance benefits.  The client retained us after his own automobile insurer rescinded his insurance policy (cancelled it retroactively) and denied multiple claims that he had pending against the insurer (a claim for vandalism damages and a separate claim due to a motor vehicle collision). 

As is common in cases involving an alleged “material misrepresentation,” the insurer had waited until after the client had been involved in a loss before asking him to give a statement explaining certain information that was contained in his application for insurance.  In this particular case, the alleged material misrepresentation was based upon the fact that the client was listed in the application for insurance as being married to his girlfriend although the two were not legally married (it’s important to note that the client denied having made that representation to the insurance company’s agent).  According to the insurer, it would have charged an additional premium when it issued the policy had it known the information that it conveniently “discovered” after the accident.

However, after filing suit and thoroughly reviewing the insurance policy and claims materials that we received from both the client and his insurer, we were able to show the insurer that it had effectively waived its defense of material misrepresentation because of the way in which it had handled the vandalism claim.  As a result, the insurer voluntarily settled all of the client’s claims for insurance benefits and paid our claims for reasonable attorney’s fees and costs. 

As part of the settlement, the insurer also agreed to the entry of a final declaratory judgment affording coverage to the client for the entire policy period for which an insurance premium had been paid.