An applicant for a comprehensive health insurance policy intentionally lies about a pre-existing heart condition on the application to secure coverage. To facilitate the approval process, the insurance agent alters the medical questionnaire after it was signed, crossing out a previous doctor's visit without having the applicant initial the change. The insurer later discovers both the applicant's lie and the agent's alteration. Which of the following statements correctly describe the legal consequences and classifications of these actions? (Select two correct answers)
- The applicant's intentional concealment constitutes a material misrepresentation, granting the insurer the legal right to void the policy.Cevap
- The agent committed a fraudulent act by altering the signed medical questionnaire without obtaining the applicant's authorizing initials.Cevap
- CThe applicant's statements on the application are considered absolute warranties, meaning any inaccuracy automatically cancels the contract regardless of its materiality.
- DThe agent's modification of the application is legally permissible if the agent believed it was correcting an obvious error to expedite the underwriting process.
Cevap
The correct statements are that the applicant's lie is a material misrepresentation allowing the insurer to void the policy, and the agent's unauthorized alteration is a fraudulent act.
The correct statements accurately identify two distinct legal violations. First, the applicant's deliberate omission of a heart condition is a material misrepresentation because it directly influences the underwriting decision, providing the insurer with grounds to void the coverage. Second, the agent's action of altering a signed application without securing the applicant's initials is strictly prohibited by state insurance regulations and constitutes an unauthorized, fraudulent change.
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Anahtar Kavram
Fraud, Material Misrepresentation, and Unauthorized Application Changes