Declaring a Policy Void
When a Policy Is Void
For Subscribers to Excellence in Claims Handling
You can Subscribe for only $5 a month to Excellence in Claims Handling at
https://barryzalma.substack.com/subscribe
A small portion of what was provided to subscribers.
In almost every policy of insurance, there is a clause declaring the policy void if the insured misrepresents or conceals material facts or commits fraud. For example:
We do not pay for bodily injury or property damage which is expected by, directed by, or intended by an insured. This exclusion does not apply to bodily injury that arises out of the use of reasonable force to protect people or property. (AAIS Form BP-200, (c) 1987 AAIS).
or:
This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other “insured,” at any time, intentionally conceal or misrepresent a material fact concerning: a. This Coverage Form; b. The covered “auto”; c. Your interest in the covered “auto”; or d. A claim under this Coverage Form. (Insurance Services Office form CA 00 01 01 87).
The policy wording requires that the insurer prove, not only that the insured misrepresented or concealed a material fact but must also prove that the insured did so with the intent to deceive.
Absent the rare confession it is often difficult to prove intentional deceit. The insured will usually claim that he or she was mistaken and had no intent to deceive. In more than 50 years of investigation of fraudulent insurance claims I only once received from an insured an under oath statement that the insured intentionally deceived the insurer and then, not in person, but by correcting false testimony in the transcript of an examination under oath.
If fraud or mutual mistake is an issue, insurers and insureds doing business in Oklahoma must resort to courts of general jurisdiction for a determination of contractual rights.[1] In Oklahoma, the Workers’ Compensation court does not have the right to rescind or declare a policy of Workers’ Compensation insurance void. However, where there is a misrepresentation with intent to deceive and the putative insured recognized the materiality of the misrepresentation the insurance policy is void from its inception.[2]
In Florida, Florida Statutes (2006), state in pertinent part:
any insurance fraud shall void all coverage arising from the claim related to such fraud under the personal injury protection coverage of the insured person who committed the fraud.
In harmony with this statutory provision, the fraud provision in an insurance policy set forth: “any insurance fraud shall void all personal injury protection coverage arising from the claim with respect to the insured who committed the fraud” is appropriate and enforceable. [Bosem v. Commerce & Indus. Ins. Co., 35 So.3d 944 (Fla. App., 2010)]
When a Policy Is Void
For Subscribers to Excellence in Claims Handling
You can Subscribe for only $5 a month to Excellence in Claims Handling at
https://barryzalma.substack.com/subscribe
A small portion of what was provided to subscribers.
In almost every policy of insurance, there is a clause declaring the policy void if the insured misrepresents or conceals material facts or commits fraud. For example:
We do not pay for bodily injury or property damage which is expected by, directed by, or intended by an insured. This exclusion does not apply to bodily injury that arises out of the use of reasonable force to protect people or property. (AAIS Form BP-200, (c) 1987 AAIS).
or:
This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other “insured,” at any time, intentionally conceal or misrepresent a material fact concerning: a. This Coverage Form; b. The covered “auto”; c. Your interest in the covered “auto”; or d. A claim under this Coverage Form. (Insurance Services Office form CA 00 01 01 87).
The policy wording requires that the insurer prove, not only that the insured misrepresented or concealed a material fact but must also prove that the insured did so with the intent to deceive.
Absent the rare confession it is often difficult to prove intentional deceit. The insured will usually claim that he or she was mistaken and had no intent to deceive. In more than 50 years of investigation of fraudulent insurance claims I only once received from an insured an under oath statement that the insured intentionally deceived the insurer and then, not in person, but by correcting false testimony in the transcript of an examination under oath.
If fraud or mutual mistake is an issue, insurers and insureds doing business in Oklahoma must resort to courts of general jurisdiction for a determination of contractual rights.[1] In Oklahoma, the Workers’ Compensation court does not have the right to rescind or declare a policy of Workers’ Compensation insurance void. However, where there is a misrepresentation with intent to deceive and the putative insured recognized the materiality of the misrepresentation the insurance policy is void from its inception.[2]
In Florida, Florida Statutes (2006), state in pertinent part:
any insurance fraud shall void all coverage arising from the claim related to such fraud under the personal injury protection coverage of the insured person who committed the fraud.
In harmony with this statutory provision, the fraud provision in an insurance policy set forth: “any insurance fraud shall void all personal injury protection coverage arising from the claim with respect to the insured who committed the fraud” is appropriate and enforceable. [Bosem v. Commerce & Indus. Ins. Co., 35 So.3d 944 (Fla. App., 2010)]
Declaring a Policy Void
When a Policy Is Void
For Subscribers to Excellence in Claims Handling
You can Subscribe for only $5 a month to Excellence in Claims Handling at
https://barryzalma.substack.com/subscribe
A small portion of what was provided to subscribers.
In almost every policy of insurance, there is a clause declaring the policy void if the insured misrepresents or conceals material facts or commits fraud. For example:
We do not pay for bodily injury or property damage which is expected by, directed by, or intended by an insured. This exclusion does not apply to bodily injury that arises out of the use of reasonable force to protect people or property. (AAIS Form BP-200, (c) 1987 AAIS).
or:
This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other “insured,” at any time, intentionally conceal or misrepresent a material fact concerning: a. This Coverage Form; b. The covered “auto”; c. Your interest in the covered “auto”; or d. A claim under this Coverage Form. (Insurance Services Office form CA 00 01 01 87).
The policy wording requires that the insurer prove, not only that the insured misrepresented or concealed a material fact but must also prove that the insured did so with the intent to deceive.
Absent the rare confession it is often difficult to prove intentional deceit. The insured will usually claim that he or she was mistaken and had no intent to deceive. In more than 50 years of investigation of fraudulent insurance claims I only once received from an insured an under oath statement that the insured intentionally deceived the insurer and then, not in person, but by correcting false testimony in the transcript of an examination under oath.
If fraud or mutual mistake is an issue, insurers and insureds doing business in Oklahoma must resort to courts of general jurisdiction for a determination of contractual rights.[1] In Oklahoma, the Workers’ Compensation court does not have the right to rescind or declare a policy of Workers’ Compensation insurance void. However, where there is a misrepresentation with intent to deceive and the putative insured recognized the materiality of the misrepresentation the insurance policy is void from its inception.[2]
In Florida, Florida Statutes (2006), state in pertinent part:
any insurance fraud shall void all coverage arising from the claim related to such fraud under the personal injury protection coverage of the insured person who committed the fraud.
In harmony with this statutory provision, the fraud provision in an insurance policy set forth: “any insurance fraud shall void all personal injury protection coverage arising from the claim with respect to the insured who committed the fraud” is appropriate and enforceable. [Bosem v. Commerce & Indus. Ins. Co., 35 So.3d 944 (Fla. App., 2010)]
0 Commenti
0 condivisioni
189 Views
English
Arabic
French
Spanish
Portuguese
Deutsch
Turkish
Dutch
Russian
Romaian
Portuguese (Brazil)
Greek