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For any major amount of life insurance, most insurance companies require that the applicant for coverage undergo a physical examination to be certain that they are healthy. An applicant for a $3 million life insurance policy in Arkansas underwent a physical examination and passed. However, before the policy could be issued, the man underwent a different coronary test that showed that he had a 90% chance of a heart attack and a high risk of cardiovascular disease. When the insurer issued the policy it contained an express affirmation that the representations in the application were unchanged. Nobody said otherwise.
Six months later the insured died and the firm in which he was a partner filed a claim under the policy. The insurer investigated, found out about the subsequent adverse medical examination, and denied coverage on the basis that the insurer had not been advised of the second examination before the policy was issued. The beneficiaries filed suit in federal court, alleging that under Arkansas law the insured was under no obligation to report the findings of that second exam to the insurer. The federal district court disagreed, finding for the insurer. The court agreed that while Arkansas law requires that insurance policies be construed most strongly against the insurer that prepares the policy, if a reasonable construction may be given to the contract that would justify a different position, it is the duty of the court to consider it.
Rescinding an insurance policy based on mistakes or misrepresentations in applications is rare, but the courts do carefully analyze the facts in each individual case. No matter what type of claim is involved, examining the accuracy of the application is a necessary part of the coverage investigation whenever there is a questionable claim. How to investigate coverage is a key part of every property and casualty course offered through Crawford Educational Services. Students taking classroom or computer courses are instructed on how coverage investigation, from the Declarations Page to the exclusions and conditions, must be conducted. For complete course listings, visit our website.
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404.300.1526 | |
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This class is designed to provide the experienced truck accident adjuster with the knowledge and skill sets to handle special cargo claims, in addition to those resulting from truck wrecks.
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Basic Casualty
April 27-May 1
This course combines
online pre-study and a one (1) week classroom, instructor led, skill application lab. Upon completion of training, the entry level casualty adjuster will have been exposed to the knowledge and technical skills necessary to enable them to handle casualty claims while under supervision.
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At Crawford Educational Services, you'll get hands-on training from our expert instructors. We offer classes in property, casualty, and workers' compensation in our classroom facility in Atlanta, as well as customized programs at your location. | |
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Take Note! is a marketing tool of Crawford Educational Services, the training division of Crawford & Company. The contents and any referenced external materials are not intended to and should not be construed as legal or other professional advice, nor is such information intended to be nor should it be used as a substitute for legal or professional counsel. These materials merely convey general information about claims and claims related situations often encountered by claims professionals. While an effort is made to be accurate, Crawford & Company does not represent, warrant, promise, or imply that this information is current, accurate, thorough, or adequate.
An Equal Opportunity Employer
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