Waiver and Estoppel
When you compare life insurance quotes make sure to ask your agent about these important elements of your contract. A “waiver” is typically defined as a voluntary relinquishment of a known right. A waiver contained in an insurance policy is an agreement that, for example, waives the liability of the insurer for a certain- type (or types) of risk ordinarily covered in the policy, such as certain types of disabilities or injuries, or death from certain causes. For example, an applicant for disability insurance who has a history of severe ulcer attacks might be offered a policy that excludes disability from ulcer attacks.
The principles of waiver and estoppel usually are combined. If you waive your rights, you may be “estopped” from reasserting them.
For example, with no fraud involved by either party, if an insurance company should investigate an applicant for insurance and, in issuing the policy, disregard facts about the applicant that were discovered in its investigation and that would have prevented it from issuing the policy, the company may be estopped from rescinding the policy by claiming the insured was uninsurable at policy inception.
To invoke estoppel, one must show detrimental reliance upon some representation, express or implied in words or in conduct. Compare life insurance prices online to avoid confusing paperwork.
Representations and Warranties
Most states have passed statutes specifying that, except in instances of fraud, all statements made by an applicant when comparing life insurance quotes (whether in the application or to a medical examiner) are considered to be representations (statements believed to be true to the best of one’s knowledge or belief) rather than warranties (statements guaranteed to be true).
The distinguishing characteristic of a warranty is that a warranted statement must be literally true. A representation, on the other hand, needs to be only substantially true. Generally, representations are considered to be fraudulent when they relate to something that materially affects the risk and were made with fraudulent intent.
Policy owners thereby are protected against the voiding of their policies on a technicality because of a misstatement in their applications. The same general rule applies to applications that are incomplete; typically, failure to disclose all pertinent information will not void a policy automatically unless it was the intent of the applicant to conceal fraudulently material facts from the insurer.
Concealment and Misrepresentation
The insured must not conceal anything from the insurer. “Concealment” is the intentional failure to disclose known facts. The applicant for insurance must make a full and fair disclosure of information pertinent to the underwriting of the risk. If the applicant intentionally failed to inform the insurer of any facts that would influence the issuance of the policy, the insurer may have grounds for voiding the policy.
“Misrepresentation” is a false statement of a fact; it may provide grounds for voiding the policy even if the misrepresentation were unintentional. However, in order to provide grounds for voiding the contract, both a misrepresentation and a concealment must involve a material fact. A “material fact is one that would have changed the underwriting basis of the policy.
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