This research does not specifically question the legitimacy of the claim, but looks to determine if insurer's opt to limit the initial underwriting process and utilize the ability to postclaim underwrite during the period set forth in the incontestability clause and after this period, when appropriate.
According to Weisbart (1976), if two otherwise identical insurers write different levels of new business, then they would have a different percentage of policies subject to the incontestability clause, which could lead to larger levels of postclaim underwriting by the insurer.
Premium growth indicates new business, which could be subject to the incontestability clause, which in turn could lead to larger levels of postclaim underwriting by the insurer (Weisbart, 1976).
The conclusion that the statute's "lifetime of the insured" provision applies to a reinstated policy when the policy does not expressly so provide is analogous to policies that fail to include an incontestability clause at all.
The result is not inconsistent with the rationale behind incontestability clauses. There is no reasonable argument that the legislature intended to protect beneficiaries, to the detriment of insurers, where the insured committed fraud and failed to satisfy the requirements of the statute.
(5.) For example, the
incontestability clause and rules regarding waiver and estoppel have been introduced into the 2009 Amendment.
The court determined that, because of the difficulty of detecting the substitution of an imposter for the insured and "to prevent manifest injustice," beneficiaries of such policies should not be protected by the incontestability clause. Moreover, it observed that the incontestability clause is designed to promote stability by creating a reasonable expectation by the insured that a claim on a valid policy will be paid: Under an imposter situation, the beneficiary had no such reasonable expectation of payment.
The court stated that Porcaro "recognized that were a jury to determine that the insured lived for two years from the date the policy issued, the statutory incontestability clause would bar any defense of fraud based on the circumstances of the insured's disappearance." (32) From this, the court concluded that "[i]f claims of potential fraud as to the fact of an insured's death--a fact most central to a life insurance contract--are subject to the statutory incontestability clause, Allstate's imposter claims cannot obviate [section] 627.455 based on their importance in the contractual scheme." (33)
I find that the protection of the incontestability clause does not extend to a wrongdoer who thwarts the investigation into the truth of his statements by posing as the independent verifier of the accuracy of the applicant's health.
1989); Annotation, Misrepresentation as to Employer-Employee Relationship as Within Incontestability Clause of Group Insurance, 26 A.L.R.
Vestal and Revere settled in 1998, but Deonier and Revere continued to litigate, with Deonier alleging that Revere breached its duties to Deonier as agent in contesting the Vestal claim without having told Deonier that it would dispute such claims notwithstanding the incontestability clause of the policy.
Deonier also engaged in considerable review of precedent regarding the incontestability clause. 9 P.3d at 625-26.
