In what circumstance can an insurer deny a claim based on 'misrepresentation'?

In what circumstance can an insurer deny a claim based on 'misrepresentation'?

• A. When the claim amount exceeds policy limits.
• B. When the insured provides incorrect information affecting coverage.
• C. When the insured fails to renew the policy.
• D. When the insurer has a conflict of interest.

Answer: (B)

An insurer can deny a claim based on misrepresentation when the insured provides incorrect information that affects the coverage. Misrepresentation occurs when a policyholder gives false details or fails to disclose important facts that would influence the insurer's decision to accept the risk or set the terms and conditions of the policy. If this incorrect information is material, meaning it would have impacted the premium or coverage decisions, the insurer has grounds to deny a claim if the truth had been disclosed. For example, if an individual claims insurance for a car that they have previously reported as excluding certain modifications, but they then provide information that omits or misrepresents the existence of those modifications, the insurer may see that as a misrepresentation. Since the accuracy of the information is critical for risk assessment, the insurer has valid grounds to deny the claim based on this misrepresentation. Other scenarios listed do not directly relate to misrepresentation in the context of insurance claims. For instance, exceeding policy limits merely relates to coverage amounts rather than the veracity of the information provided. Similarly, failure to renew a policy is a procedural matter that does not inherently involve misrepresentation. Conflicts of interest relate more to ethical considerations and governance rather than the accuracy of information provided to obtain insurance coverage.

An insurer can deny a claim based on misrepresentation when the insured provides incorrect information that affects the coverage. Misrepresentation occurs when a policyholder gives false details or fails to disclose important facts that would influence the insurer's decision to accept the risk or set the terms and conditions of the policy. If this incorrect information is material, meaning it would have impacted the premium or coverage decisions, the insurer has grounds to deny a claim if the truth had been disclosed.

For example, if an individual claims insurance for a car that they have previously reported as excluding certain modifications, but they then provide information that omits or misrepresents the existence of those modifications, the insurer may see that as a misrepresentation. Since the accuracy of the information is critical for risk assessment, the insurer has valid grounds to deny the claim based on this misrepresentation.

Other scenarios listed do not directly relate to misrepresentation in the context of insurance claims. For instance, exceeding policy limits merely relates to coverage amounts rather than the veracity of the information provided. Similarly, failure to renew a policy is a procedural matter that does not inherently involve misrepresentation. Conflicts of interest relate more to ethical considerations and governance rather than the accuracy of information provided to obtain insurance coverage.