Every fraud investigator or lawyer advising an insurer on a potentially fraudulent claim is faced, at the end of an investigation, with the need to determine whether there is sufficient grounds to deny the claim. It is not enough to believe that the insured has committed fraud. It is necessary that sufficient evidence exist to establish, beyond a preponderance of the evidence, that fraud occurred.
Two grounds upon which a denial may be effective are misrepresentation or concealment of a material fact, and false swearing.
Misrepresentation
Want to continue reading?
Become a Free PropertyCasualty360 Digital Reader
Your access to unlimited PropertyCasualty360 content isn’t changing.
Once you are an ALM digital member, you’ll receive:
- Breaking insurance news and analysis, on-site and via our newsletters and custom alerts
- Weekly Insurance Speak podcast featuring exclusive interviews with industry leaders
- Educational webcasts, white papers, and ebooks from industry thought leaders
- Critical converage of the employee benefits and financial advisory markets on our other ALM sites, BenefitsPRO and ThinkAdvisor
Already have an account? Sign In Now
© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
