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Answered 2012-05-03 17:24:21

An insurance company makes a decision to issue coverage based on the answers on the application, the company's underwriting guidelines and medical information they may receive from an attending physician's report or even blood and urine samples and test results. If an applicant or insured person makes a mis-statement about his or her health it basically voids the application. If you have been recently diagnosed with a terminal disease and buy a policy they don't have to pay the claim when you die because you did not disclose information that they would have used to determine if you were eligible. Basically you attempted to trick them and you will not win. It's kind of like wrecking your car and then buying insurance to repair it after the fact. Mis-statement on any application voids coverage.

Insurance commissioners are not there to protect insurance companies. They are they to protect consumers but you have to remember that an application for insurance coverage is part of a contract. The policy is also a contract between the applicant and the company. The insurance regulators or commissions are there to ensure the companies don't break the law and to protect the rights of the consumer. Most Departments of Insurance return millions of dollars to consumers every year and fight insurance companies and win. A lot of people don't bother filing complaints against companies because they don't think they'd win but you'd be surprised.

Thanks, Barbiejoy

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If you still think you're right - send them another letter.

If that doesn't work, contact the Insurance Commissioner, your agent or an Attorney.

AnswerThe insurance commissioner is there to protect the insurance companies, too. Not just the consumer. If there are lies on the application, you are entitled to a refund of the premiums paid. If the statements were true, you'd better get a good attorney, because the insurance company already has a good attorney. AnswerIf you have a life insurance claim that has been denied or is being delayed, you should contact the Center for Life Insurance Disputes for a free consultation.
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Answered 2015-06-23 21:28:12

It just depends on whether the assertion of untrue statements on the application are factual or not.

If the applicant for insurance lied on the application and you know this is a fact, then there is nothing to do. This is known as "Fraud through Misrepresentation" of the material facts. It would be a crime for the Insurer to pay you if they determine fraud. It could also be a crime for the recipient to accept the pay out if that recipient is aware of or was in collusion with the untrue statements used to obtain the policy.

If you disagree with the insurers conclusions of misrepresentation and feel the claim is legitimate, then you may consider getting an attorney to assert your legal rights in court to obtain our payout.

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