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Definition of material misrepresentation. In a life insurance policy, material misrepresentation occurs when the applicant makes an untrue statement that, if known, would have affected the ...
Insurers have the right to rescind an insurance policy due to concealment, material misrepresentation, or material breach of warranty. Generally, to rescind, an insurer will send a notice to the insured and tender a check in the amount of the premium paid for the relevant policy period
For example, HomeServe, an emergency home repair insurance company based in the United Kingdom, was fined £30m for misselling to its customers by the Financial Conduct Authority in February 2014, as they had failed to explain the actual price and the coverage of their financial products.
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The law of misrepresentation is an amalgam of contract and tort; and its sources are common law, equity and statute. In England and Wales, the common law was amended by the Misrepresentation Act 1967. The general principle of misrepresentation has been adopted by the United States and other former British colonies, e.g. India.
Falsification of a material fact that would cause a party to a contract to refrain from entering into the contract may be grounds for rescission. For example, misrepresentation of a material fact on an application for insurance may give an insurance company grounds to rescind an insurance policy. [3]
Under common law, false pretense is defined as a representation of a present or past fact, which the thief knows to be false, and which he intends will and does cause the victim to pass title of his property. That is, false pretense is the acquisition of title from a victim by fraud or misrepresentation of a material past or present fact.
Insurance fraud poses a significant problem, and governments and other organizations try to deter such activity. Studies suggest that the greatest total dollar amount of fraud is committed by the health insurance companies themselves, intentionally not paying claims and deleting them from their systems, [2] and denying and cancelling coverage. [3]