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Can an insurance company deny a claim based on “material misrepresentation” if the health issue being contested is not related to the illness or injury that has prompted the claim for benefits?

Yes. People often believe that if, for example, they have been diagnosed with a form of cancer, but the alleged misrepresentation is regarding high blood pressure, that those two items seem to be unrelated and the misrepresentation appears to be irrelevant. Claims denied based on material misrepresentation turn on the question of, firstly, whether the answer to the question was inaccurate, and secondly, whether the disclosure of the prior medical condition would have been “material” to the insurance company’s decision to issue the policy. If in doubt, contact an experienced insurance lawyer for further guidance and advice. 

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On what basis can an insurance company deny benefits on a private “own occupation” disability claim?

Simply enter a question or keyword (minimum 4 characters) in the “Ask a Question” box and a list of answers will be provided or you may view a list of popular disability claim law questions and answers.

 

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This searchable database contains information about disability, critical illness and life insurance claims, and what you can do if you are denied or cut off of your benefits. It is a collection of the most common questions we receive from our clients. General answers have been provided by our lawyers.

Here are some commonly asked questions to get you started:
My disability claim has been denied. Does that mean I am not eligible for benefits?




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