Accuracy in the Application for Insurance is Necessary to Avoid Claims of Misrepresentation

We’ve all likely seen USAA’s recent commercial campaign featuring Super Bowl Champion Rob Gronkowski attempting, unsuccessfully, to obtain insurance with USAA.

Although the commercials are lighthearted and humorous, they also raise an important point about the application for insurance benefits.

Florida Statute 627.409 governs misrepresentations in Florida. At first glance, a reader may think this is not a big deal – “I would never lie to my insurance company.” However, a deeper look at the language of the statute is needed.

Representations in applications; warranties.—

(1) . . . A misrepresentation, omission, concealment of fact, or incorrect statement may prevent recovery under the contract or policy only if any of the following apply:

(a) The misrepresentation, omission, concealment, or statement is fraudulent or is material either to the acceptance of the risk or to the hazard assumed by the insurer.

(b) If the true facts had been known to the insurer pursuant to a policy requirement or other requirement, the insurer in good faith would not have issued the policy or contract, would not have issued it at the same premium rate, would not have issued a policy or contract in as large an amount, or would not have provided coverage with respect to the hazard resulting in the loss.

Two things should jump off the page. First, the statute does not contain a knowledge requirement. There is no language such as “intentional misrepresentation” or “knowingly misrepresents.” A lack of knowledge element should give all applicants for insurance pause. A knowledge element is a requirement that the act or omission be done knowingly or intentionally.

A careful review of your responses in your insurance application is important to ensure you are not making mistakes. A mere mistake could result in you being denied coverage.

Second, there is a possibility that accidentally leaving something off your insurance application could result in no coverage as well.

Back in 2015, Chip Merlin posted an article, Rescission of Coverage When Misrepresentation in Policy Application Is Not Material to Acceptance of Risk. In that blog, Chip examined a case where the insurance policy created a knowledge requirement. It is not particularly uncommon for an insurance policy to require the statement to be knowingly made. His blog post looked further at the “materiality” of the misrepresentation.