Homeowner's Insurance Claim Denial Based on Material Misrepresentation
As Florida homeowner's insurance claims attorneys we know that one of the most common defenses or excuses to deny coverage is material misrepresentation. This material misrepresentation relates to the application one fills out to obtain coverage in the first place. Florida Statute 627.409, titled Insurance Rates and Contracts, regulates the issue of material misrepresentations to an insurance company:
... A misrepresentation, omission, concealment of fact, or incorrect statement may prevent recovery under the contract or policy only if any of the following apply:
(a)The misrepresentation, omission, concealment, or statement is fraudulent or is material either to the acceptance of the risk or to the hazard assumed by the insurer.
(b)If the true facts had been known to the insurer pursuant to a policy requirement or other requirement, the insurer in good faith would not have issued the policy or contract, would not have issued it at the same premium rate, would not have issued a policy or contract in as large an amount, or would not have provided coverage with respect to the hazard resulting in the loss.
In other words, a misrepresentation or omission alone is not sufficient to deny a claim or void a policy. The said misrepresentation would need to have an effect on whether the insurer would have accepted the policy in the first place, or whether it would have provided coverage at a higher premium. To determine whether a material misrepresentations exists it is key to look at the insurance application. Ambiguities in application are construed liberally and in favor of the insured by Florida Courts. Furthermore, any ambiguity is analyzed strictly against the insurer who prepared the policy. See Prudential Prop. & Cas. Ins. Co. v. Swindal, 622 So.2d 467, 470 (Fla.1993). It should be noted that determination of whether a material misrepresentation exists is matter that should be determined by a trier of fact or a jury.
It could be that your insurance company may be aware of an error or misrepresentation on your policy and continue to accept your premium payments. Under these circumstances the insurer has waived its right to rescind a policy or deny a claim on the basis of material misrepresentation. (See Johnson v. Life Ins. Co. of Georgia, 52 So.2d 813, 816 (Fla.1951)). Dealing with issues of denial due to a homeowner's alleged material misrepresentation can very complicated. It wise to hire a Miami homeowner's insurance lawyer to assists with such issues, or any complication regarding your property coverage. Insurance companies have their lawyers and so should you. Insurance companies may use all tools they have at their disposal to mitigate their claim, or deny it altogether.
If you have suffered a loss at your home it is important to document it and report to your insurance company. Make sure to take pictures before any repairs are completed. Also, keep receipts and records of any repairs you may make. Do everything you can to stop the loss from getting worse. Fort Lauderdale homeowners insurance claims attorneys are here to assist you 24/7. We can be reached at 1.888.413.8353.