Direct answer
Claims are often denied for material misrepresentation if the applicant failed to disclose a pre-existing medical condition that would have changed the insurer’s underwriting decision. To appeal, you must provide medical records or statements proving the condition was not known or not material to the policy at the time of application.
State-specific insurance code and contract law governing disclosure requirements in insurance applications. For additional information about state-specific regulatory standards, see the National Association of Insurance Commissioners (NAIC) website.
What this means for you
Claims are often denied for material misrepresentation if the applicant failed to disclose a pre-existing medical condition that would have changed the insurer’s underwriting decision. To appeal, you must provide medical records or statements proving the condition was not known or not material to the policy at the time of application.
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