LIFE INSURANCE CLAIMS
Life insurance policies are agreements between a policyholder and an insurance company which provides for the lump sum payment of a death benefit to a named beneficiary upon the death of the policyholder.
An insurance company can deny payment of a death benefit due to allegations that the policyholder has provided false or inaccurate answers to questions in a life insurance application. For instance, the insurance may seek to deny payment of a death benefit due to an alleged material misrepresentation where it is claimed that the policyholder inaccurately described their medical history. To deny the payment of a death benefit, not only must the insurance company prove that there was a misrepresentation, but also that the misrepresentation was material.
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The Insurance Act
Furthermore, under the Ontario Insurance Act, where a life insurance policy has been in place for at least two years, the policy becomes incontestable, which means that the insurance company faces the heavy burden of proving that the misrepresentation was fraudulent.
