Legal Guide

Misrepresentation in Life Insurance Applications — Legal Defenses

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Misrepresentation in Life Insurance Applications — Legal Defenses

When a loved one passes away, families expect their life insurance to provide financial security. But "misrepresentation" is one of the most common reasons Alberta insurers **refuse** to pay legitimate life-insurance claims.

The alleged errors are often **minor, unintentional, or irrelevant** to the cause of death—yet insurers use these technicalities to delay or deny payment, leaving families struggling during an already difficult time.

As Alberta insurance lawyers, we know exactly how misrepresentation is handled—and most families are unaware of their **strong legal defenses**.

This article explains what constitutes misrepresentation, how insurers use it to deny claims, and how Alberta law provides **powerful legal defenses** that can overturn these denials.

This guide covers:

What is a life insurance claim
What counts as misrepresentation
How insurers investigate misrepresentation
Legal defenses against misrepresentation denials
When misrepresentation becomes bad faith
Evidence that strengthens legal defenses
How to protect yourself when applying
Alberta-specific rules and deadlines

What Is a Life Insurance Claim?

A life-insurance claim is seeking payment of the **death benefit** after an insured person dies. Claims in Alberta fall under three main policy types:

Types of Life Insurance Policies:

Group Life InsuranceCoverage through employers or professional associations. Usually limited in amount and requires little to no medical underwriting.
Individual Life InsurancePurchased privately through an insurer or broker. Requires full disclosure of medical history, lifestyle, and occupation.
Mortgage or Credit Life InsurancePays off a mortgage or loan on death. Often includes minimal underwriting and broad denial rights for insurers.

How Insurers Investigate Misrepresentation

When a claim is filed, especially during the **two-year contestability period**, insurers launch detailed investigations:

1

Collecting Medical Records

Collecting **medical records** from all treating doctors and clinics.

2

Reviewing Pharmacy Databases

Reviewing pharmacy databases for undisclosed prescriptions.

3

Comparing Application Answers

Comparing application answers against clinical notes.

4

Interviewing Brokers

Interviewing the broker or financial advisor.

5

Analyzing Cause of Death

Analyzing **cause of death** to see if it relates to undisclosed conditions.

Even a small discrepancy can trigger a denial letter — but most investigations are one-sided and omit context.

Common Insurance Challenges in Alberta

Life insurers frequently allege misrepresentation when:

Undisclosed Medical Diagnosis or Medication

An applicant forgot to mention a medical diagnosis or medication.

Undisclosed Doctor's Visit

A doctor's visit wasn't disclosed.

Under-Reported Lifestyle Information

Smoking, alcohol, or mental-health history was under-reported.

Inaccurate Lifestyle Information

The insurer believes lifestyle information was inaccurate.

Has your claim been denied for 'misrepresentation'?

Contact us today for a free consultation

How Lawyers Challenge Misrepresentation Denials

Experienced Alberta insurance lawyers use both legal and medical evidence to dismantle misrepresentation claims.

Review the Full Policy and Application

Identify ambiguity or procedural flaws.

Gather Medical Evidence

Show the omission was minor, unrelated, or misunderstood.

Obtain Expert Underwriting Opinions

Demonstrate the insurer would have issued coverage regardless.

Negotiate or Litigate

Push for reinstatement or full payment, plus interest.

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Frequently Asked Questions

Conclusion

Insurers often use "misrepresentation" as a convenient reason to deny payment — even when the truth is that your loved one made an honest mistake. Alberta law protects families against that kind of overreach.

Only material, **intentional misstatements** can void a policy.

After **two years**, only proven fraud matters.

Ambiguities are interpreted **in favour of the insured**.

You have strong **legal defenses** and access to compensation for bad-faith conduct.

Still have questions? Contact us today for a free consultation.

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