When life insurance benefits are denied, this can leave surviving family members in financial hardship while grieving the loss of a loved one.
Insurance companies deny life insurance benefits for a wide variety of reasons, including:
- Material misrepresentation;
- Fraudulent misrepresentation;
- Suicide; or,
- Drug use or intoxication contributing to the death of the policy holder.
A material misrepresentation is found if the insured person failed to disclose information at the time of their application for life insurance, which would be regarded by a reasonable insurer as material to the risk. If anything, material should have been disclosed but was not, then the Court would consider whether the disclosure of that information would have caused the insurance company to decline the risk or to require higher premiums.
What life insurance companies sometimes fail to realize is that they must be able to establish that the true facts were within the person’s knowledge. The Ontario Superior Court of Justice has stated that, even if there is medical information that should have been disclosed in response to a question on an application for life insurance, if the insured did not have the necessary knowledge, he or she cannot be found liable for non-disclosure. In that case, the insurance company would not be able to deny life insurance payments based on a misrepresentation.
How much time elapsed between the life insurance being issued and the death of the policy holder matters as well. When an insured person dies more than 2 years after the life insurance policy was issued, the insurer has a much harder time avoiding payment based on a misrepresentation. This is because, after the 2 years, the insurer must prove that the misrepresentation was fraudulent; an innocent misrepresentation would not be enough.
Contact Graves & Richard at 226-401-5306 to get started on your free one-hour consultation. Our lawyers practice strictly personal injury law for individuals to recover damages for injuries and losses suffered as a result of motor vehicle accidents, slip and falls, dog bites and many other areas, all of which are listed on our site.