If a statement is an opinion or belief rather than a fact, what must the insurer prove to deny a claim?

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Prepare for the Risk Management Temple Exam 2. Study with interactive quizzes, flashcards, and detailed explanations for each question. Boost your readiness and confidence for the exam!

Multiple Choice

If a statement is an opinion or belief rather than a fact, what must the insurer prove to deny a claim?

Explanation:
When a statement is only an opinion or belief, it isn’t a factual misstatement that can be used to deny a claim. The insurer can deny on the basis of misrepresentation only if there was a false statement of a material fact or concealment with the intent to deceive. So, to deny a claim in this situation, the insurer must prove fraudulent behavior—the insured knowingly made a false statement of material fact (or concealed relevant information) with the aim to mislead the insurer. If there’s no fraud, an opinion cannot be treated as a misstatement to void coverage.

When a statement is only an opinion or belief, it isn’t a factual misstatement that can be used to deny a claim. The insurer can deny on the basis of misrepresentation only if there was a false statement of a material fact or concealment with the intent to deceive. So, to deny a claim in this situation, the insurer must prove fraudulent behavior—the insured knowingly made a false statement of material fact (or concealed relevant information) with the aim to mislead the insurer. If there’s no fraud, an opinion cannot be treated as a misstatement to void coverage.

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