JANET VARELAS, APPELLANT,
v.
BLUE CROSS OF FLORIDA, INC., AND BLUE SHIELD OF FLORIDA, INC., ETC., APPELLEES
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Appellant sought recovery under a medical expense insurance policy, but the insurer denied liability based on material misrepresentations in the application. The trial court granted the insurer's motion for directed verdict after a jury verdict for the plaintiff, and the appellate court affirmed, holding that the misrepresentations satisfied the statutory requirements for denial of coverage under Florida law.
The court held that no reversible error was shown. Under § 627.409, misrepresentations do not prevent recovery unless the insurer in good faith would not have issued the policy, would not have issued it at the same premium rate or in the same amount, or would not have provided coverage for the hazard resulting in the loss if the true facts had been known. Here, the judgment's findings satisfied this statutory requirement.
[1] Misrepresentations, omissions, concealment of facts, and incorrect statements in an insurance application do not prevent recovery under a policy unless the insurer, in go…
[2] A directed verdict for an insurer is proper when the evidence shows that misrepresentations in an insurance application were material to the acceptance of the risk or the…
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Join FLexlaw to unlock all legal intelligence“misrepresentations, omissions, concealment of facts and incorrect statements shall not prevent a recovery under a policy, unless, among other things, the insurer in good faith would either not have issued the policy or would not have issued it at the same premium rate or in as large amount, or would not have provided coverage for the hazard resulting in the loss, if the true facts had been made known to the insurer as required”
Statement of the statutory protection in § 627.409 Fla.Stat. that protects insureds from misrepresentations unless they meet specific conditions
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Join FLexlaw to unlock all legal intelligenceAppellant Janet Varelas filed a complaint seeking recovery under a medical expense policy issued by Blue Cross of Florida, Inc. and Blue Shield of Flo…
The full statement of facts, procedural history, and disposition for this case are member content.
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By a complaint filed in the circuit court of Dade County the appellant sought recovery under a medical expense policy. The defendant insurer’s answer averred material misrepresentations in the insurance application. On trial of the cause a verdict was rendered in favor of the plaintiff. The defendant moved for an order *562granting its motion for directed verdict made at the close of the case, upon which ruling had been reserved. The court granted the motion and entered judgment for the defendant, from which the plaintiff appealed.
Appellant contends the court committed error for the reason that the misrepresentations should not have been held to constitute basis for denying liability under the policy, relying on § 627.409 Fla.Stat., F.S. A.
We hold reversible error has not been shown. The section of the statute cited by the appellant provides that misrepresentations, omissions, concealment of facts and incorrect statements shall not prevent a recovery under a policy, unless, among other things, the insurer in good faith would either not have issued the policy or would not have issued it at the same premium rate or in as large amount, or would not have provided coverage for the hazard resulting in the loss, if the true facts had been made known to the insurer as required, either by the application or otherwise.
The judgment contained statement of a number of grounds therefor, including one which showed judgment for the defendant insurer was not contrary to or inconsistent with the provisions of § 627.409 Fla.Stat., F.S.A., viz:
“2. Said application contained misrepresentations, omissions, concealment of facts and incorrect statements which were material to the acceptance of the risk as well as the hazard assumed by the Defendants and had the Defendants known the truth and correctness of the answers to said questions the Defendants, in good faith, would either not have issued the policy or the Defendants would not have provided coverage with respect to the hazard resulting in the loss or the Defendants would have issued riders against the policy to protect against the hazard.”
The judgment is affirmed.