What is Misrepresentation and How Does It Affect Insurance Claims? 
Misrepresentation is a broad term that can involve a range of inaccuracies or omissions made by the policyholder during the application process. It often includes providing false information about medical history, lifestyle habits, or other material factors that could influence the insurer’s decision to approve or deny coverage. There are two primary types of misrepresentation: innocent misrepresentation and fraudulent misrepresentation. Innocent misrepresentation occurs when the policyholder unintentionally provides incorrect information, while fraudulent misrepresentation involves intentionally providing false information to deceive the insurer. In the event of a life insurance claim denial, the insurer must prove that the misrepresentation was significant enough to affect the decision to issue the policy. In some cases, even innocent misrepresentations can result in claim denials, although fraudulence may be treated more severely. 
Challenging a Denied Life Insurance Claim in New York
When a life insurance claim is denied based on misrepresentation, New York law provides beneficiaries with several potential courses of action. Understanding your rights and responsibilities is crucial in navigating the appeal process. The first step in challenging a claim denial is to thoroughly review the insurer’s denial letter. The insurer is required to outline the specific reasons for denying the claim, including the exact nature of the misrepresentation they claim occurred. This will serve as the foundation for any appeal or legal action.The Two-Year Contestability Period in New York
New York law protects beneficiaries by offering a two-year contestability period for life insurance policies. This period begins on the policy’s issuance date and lasts for two years. During this time, the insurer has the right to investigate the policyholder’s application for misrepresentation. However, after the two-year period expires, the insurer can no longer contest the validity of the policy unless they can demonstrate that the misrepresentation was fraudulent. The two-year contestability period is significant because it provides beneficiaries with a level of protection. If the policyholder dies after the contestability period, the insurer cannot deny the claim solely based on misrepresentation unless fraud is proven. This is an essential factor to consider when assessing whether a denial due to misrepresentation is valid.Understanding Material vs. Immaterial Misrepresentation
Not all misstatements made on an insurance application will result in a denied claim. For a misrepresentation to be grounds for a denial, the information must be considered material. Material misrepresentation refers to any false information that could have influenced the insurer’s decision to provide coverage or set the policy’s terms.
We contacted Trief & Olk to help us with a life insurance issue and Shelly Friedland was the attorney assigned to our case. Before Shelly took our case she explained to us that the likelihood of our success without going to court was possible but not likely. Unfortunately we did not get the outcome we had hoped for but it was our decision to not move forward and have our case litigated. Shelly is very knowledgeable and was very straight-forward in her assessment of our case as we moved forward. She was very patient and thorough in answering our questions. She always responded in a timely manner and listened to our concerns. We would certainly recommend Shelly and would use her firm again in the future.”
- John Ramig
If there is any possibility of winning your life insurance case – this is the place to do it for you. They are efficient, honest and will achieve the best possible outcome.
Shelly Friedland worked on my case where a life insurance policy had lapsed and was even a few days beyond the grace period. Farmers had rejected my claim twice and was unwilling to take a second look. Shelly was able to get them to pay the entire claim without going to court, and the full amount was deposited in my account within a couple months. Highest recommendation.”
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Trief & Olk is a superior law firm. Their attorneys and other legal professionals have a brilliant understanding of the law and the litigation process. They diligently perform their work in an efficient, strategic and cost-effective manner to ensure the best possible outcomes for their clients.
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