Case Law – Fioretti v. Mass. General Life

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What must be disclosed on an Insurance Application

MassGen agreed to underwrite Anthony Fioretti’s life insurance policy, contingent only upon his execution of the Statement of Good Health.

Even after the expiration of the contestability period, an insurer may deny a claim if the insured committed fraud in the policy application.  To rescind a policy, an insurer need not show that the insured actually intended to deceive.  Even an innocent misrepresentation can constitute equitable fraud justifying rescission.   (even after lapse of contestability period, a health insurer may deny coverage based on insured’s nondisclosure of a serious illness in his insurance application);  (recession authorized when insured knowingly misrepresents material health information to health insurer); (same when misrepresentations made to life insurer).

at the time he completed this

Statement of Good Health, Anthony Fioretti knew:

(1) that he was HIV- positive;
(2) that he had previously been declined life insurance by another carrier (Columbian Mutual); and
(3) that he had previously consulted with at least two doctors concerning his HIV status.

In short, every representation made by Anthony Fioretti in the Statement of Good Health was false

The California Court of Appeal, for the first time since 1988, has agreed that when an insured misrepresents or conceals, in an application for insurance, facts subjectively material to the underwriter who agreed to the risk, the insurer may effectively rescind the policy

The rule that an insurer is estopped to claim misrepresentation in an insurance application caused by the insurance agent’s negligence does not apply where the applicant receives a copy of his application, unless some action by the agent prevents the applicant from reading the policy or leads the applicant to believe that the misstated or omitted answers are not material. Rutherford v. Prudential Ins. Co. of America 234 Cal.App.2d 719 Cal.App.1.Dist.,1965.

Question in application for life insurance as to whether applicant had ever had headaches, chest pains, above normal blood pressure, and whether applicant had consulted physician during past five years for any other cause, called for matters of fact normally within knowledge of every layman, and there was substantial, though mainly indirect, evidence that answers of deceased in application constituted both knowing misrepresentations and concealment of truth. Anaheim Builders Supply, Inc. v. Lincoln Nat. Life Ins. Co. (App. 5 Dist. 1965) 43 Cal.Rptr. 494, 233 Cal.App.2d 400. Insurance

This case may no longer be VALID law.  Check with your attorney and review the other pages on this website, namely, prohibitions on recission.

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