Why insurers need proper evidence in order to prove material misrepresentation?
In Jarvis McKiver v. Windhaven Insruance Company, 26 Fla. L. Weekly Supp. 320a (13th Judicial Circuit in and for Hillsborough County, June 7, 2018), the Court granted summary judgment in favor of the insured on the issue of material misrepresentation.
In finding for the insured, the Court held that the insurer’s opposing affidavit, on which the insurer relied as evidence that the premium rate would have changed if the insurer’s co-resident grandmother had been listed on the application for insurance, is inadmissible hearsay and not based on personal knowledge of the affiant. As a result of the Court’s finding that the affidavit was based on inadmissible hearsay and not based upon the affiant’s personal knowledge, the Court struck the affidavit.
This case illustrates an important point. Very often, medical providers will write-off PIP cases as being lost causes, particularly in situations such as material misrepresentation cases. The medical provider gets notice from the insurer that the policy of insurance is rescinded due to material misrepresentation, and that there is no policy to provide coverage.
As with many other cases, the insurance company made a huge mistake in this material misrepresentation case: they did not have the proper evidence. In many cases, the insurance company has incorrect information on which they base their rescission. In other cases, the insurance company has an ambiguous policy and/or insurance application, which could be read any number of ways. Still, in other cases, the correct information could have been relayed to the insurance agent, but the insurance agent put down incorrect information.
It is important for medical providers to send all PIP cases to a qualified PIP attorney. While there is no guarantee of success in every case, a qualified PIP attorney will help a medical provider to maximize the recovery of PIP benefits. If you are a medical provider and want more information about this case or would like us to review your PIP claims, please do not hesitate to contact Attorney Lyle B. Masnikoff or Attorney Kevin Davies at (877) 817-4127.
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