170k views
3 votes
Khloe applies for a life insurance policy with DangerCo Insurance Company. When completing the application form about past surgeries, Khloe forgot about a past outpatient procedure when she had a gash in her leg treated and bandaged. Three years after obtaining the policy, Khloe died suddenly from a stroke. DangerCo denied payment under the policy based on misrepresentation. If Khloe's sister, Courtney, sues DangerCo, she will most likely (True/False)

User Douglas B
by
8.0k points

1 Answer

2 votes

Final answer:

Courtney may likely win the case against DangerCo Insurance Company, as the undisclosed minor outpatient procedure appears unrelated to Khloe's death caused by a stroke. The success of a lawsuit would depend on demonstrating that the omission was not material to the cause of death, and as such, should not have affected the life insurance coverage.

Step-by-step explanation:

The student has asked whether Khloe's sister, Courtney, will most likely win or lose a lawsuit against DangerCo Insurance Company on the grounds of misrepresentation after the insurance company denied payment under the life insurance policy following Khloe's unexpected death from a stroke.

In this scenario, the fact that Khloe forgot to mention a past outpatient procedure for a gash in her leg does not seem to bear any relevance to the cause of her death (a stroke). Assuming that the cause of death (the stroke) was not related to the undisclosed leg treatment, the case of misrepresentation may not be strong for the insurance company.

Insurance companies rely on accurate information to assess risk, but minor inadvertent omissions that are unrelated to the claim typically would not be grounds for denial of payment. Misrepresentation in an insurance application must be significant and related to the claim. In the legal realm, the materiality of the omission is a key factor.

Therefore, if Courtney takes action against DangerCo on these grounds, she may have a strong case against the denial of the life insurance claim, as the omission in the application does not seem to be material to Khloe's cause of death. The information provided by the insured would need to be shown to have affected the risk being insured against.

User Or Smith
by
7.8k points