Examkin

Soru

Zorluk: KolayCompleting the Application

An insurance company receives a medical expense application but notices that the question asking about a family history of diabetes is left entirely blank. Instead of returning the application for completion, the insurer approves the risk and issues the policy. If the insured files a claim for diabetes treatment a year later, what action is the insurer legally required to take regarding this claim?

  1. A
    Deny the claim on the grounds of material concealment by the applicant during the application process
  2. Pay the claim in full because issuing the policy with an unanswered question waived the insurer's right to that informationCevap
  3. C
    Cancel the policy immediately and refund all previously paid premiums due to an incomplete application
  4. D
    Deduct the cost of the additional underwriting risk from the final claim payment

Cevap

The insurer must pay the claim in full because accepting an incomplete application constitutes a waiver of their right to that specific information.
The correct answer accurately reflects the legal doctrine of waiver in insurance underwriting. If an insurance company receives an application with missing information and issues the policy anyway, the company has legally waived its right to that information. They must honor the contract and pay covered claims, as they can no longer argue that the missing information was material to their underwriting decision.

Adım Adım Çözüm

1
Analyze the status of the application when it was received by the insurer.
The application was incomplete because a question about diabetes history was left blank.
Identifying the initial error is necessary to determine the responsibilities of the agent and the insurer.
2
Evaluate the insurer's response to the incomplete application.
The insurer chose to issue the policy instead of returning the application to the applicant for completion.
The insurer's action dictates the legal standing of the contract.
3
Apply the legal concept of waiver to the insurer's action.
By issuing the policy, the insurer voluntarily relinquished (waived) its right to require an answer to that specific question.
Under insurance law, if an insurer issues a policy with unanswered questions, they cannot later use the missing information to deny a claim or void the policy.

Anahtar Kavram

Handling Incomplete Applications and the Doctrine of Waiver
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Konular

Completing the Application

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