Key Takeaway
New York court clarifies the high burden insurers face when claiming material misrepresentation as a defense to deny coverage in no-fault insurance cases.
This article is part of our ongoing material misrepresentation - procurement of insurance policy coverage, with 24 published articles analyzing material misrepresentation - procurement of insurance policy issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Understanding Material Misrepresentation in Insurance Defense
Insurance companies frequently attempt to deny coverage by claiming that policyholders made material misrepresentations during the application process. However, New York courts have established strict standards that insurers must meet to successfully use this defense. The burden of proof is particularly high, requiring insurers to demonstrate not just that a misrepresentation occurred, but that it was material enough to have changed their underwriting decision.
This defense strategy has evolved significantly over time. What was once commonly referred to as fraudulent procurement has transformed into the more nuanced material misrepresentation defense, reflecting changes in how courts interpret insurance law. Understanding this evolution is crucial for both practitioners and policyholders navigating insurance disputes.
Jason Tenenbaum’s Analysis:
Alignment Chiropractic, P.C. v Travelers Home & Mar. Ins. Co., 2020 NY Slip Op 50994(U)(App. Term 2d Dept. 2020)
“A misrepresentation is material if the insurer would not have issued the policy had it known the facts misrepresented. To establish materiality as a matter of law, the insurer must present documentation concerning its underwriting practices, such as underwriting manuals, bulletins, or rules pertaining to similar risks, that show that it would not have issued the same policy if the correct information had been disclosed in the application” (Interboro Ins. Co. v Fatmir, 89 AD3d 993, 994 )”
“Upon a review of the record, we find that defendant failed to establish as a matter of law that it would not have issued the policy in question. Consequently, defendant did not demonstrate, prima facie, that the misrepresentation by plaintiff’s assignor was material”
It is so interesting how the fraudulent procurement defense transformed itself into the material misrepresentation defense”
Key Takeaway
Insurers cannot simply claim material misrepresentation without substantial proof. They must provide concrete documentation of their underwriting practices showing they would have denied coverage if accurate information had been provided. The transformation from fraudulent procurement to material misrepresentation defense represents a significant shift in how these cases are evaluated by New York courts.
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Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
Material Misrepresentation in Insurance Policy Procurement
An insurer may void a policy ab initio if the insured made a material misrepresentation during the application process. Under New York Insurance Law 3105, the misrepresentation must be material to the risk — meaning the insurer would not have issued the policy or would have charged a higher premium had it known the truth. In no-fault practice, misrepresentation defenses can eliminate coverage entirely. These articles analyze the legal standards, the burden of proof on the insurer, and the case law governing rescission based on misrepresentation.
24 published articles in Material misrepresentation - procurement of insurance policy
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More Material misrepresentation - procurement of insurance policy Analysis
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Jul 24, 2019Material Misrepresentation Defense unsuccessful
Court rejects insurance company's material misrepresentation defense, ruling insurer failed to prove it wouldn't have issued policy with correct information disclosed.
Jul 7, 2018Fraudulent procurement defense looks more like a 3105 defense
New York court ruling establishes that fraudulent procurement defense requires same evidence standards as Insurance Law 3105 material misrepresentation claims.
Jul 10, 2016An interesting case in the realm of misrepresentations
Court finds insurer can deny coverage despite keeping premiums when policyholder misrepresented property status on application, highlighting material misrepresentation defense...
Apr 8, 2015A primer on Florida Law
Analysis of Florida vs New York no-fault insurance laws, focusing on retroactive policy rescission differences and choice of law implications in cross-state accident cases.
May 29, 2012Fraudulent procurement defense not substantiated
Bronx Civil Court rules fraudulent procurement defense unsubstantiated in Quality Med. Care v Progressive, highlighting evidentiary gaps in material misrepresentation claims.
Aug 10, 2017Common Questions
Frequently Asked Questions
What constitutes a material misrepresentation that voids an insurance policy?
Under NY Insurance Law §3105, a misrepresentation is material if the insurer would not have issued the policy had it known the truth. Common examples include failing to disclose other drivers in the household, prior accidents, or the true use of the vehicle. The misrepresentation must be in the original application, not in a subsequent claim.
Can an insurer void a no-fault policy retroactively?
Yes. If an insurer can prove material misrepresentation in the policy application under Insurance Law §3105, it can void the policy ab initio — as if it never existed. This means all claims, including no-fault benefits, are denied. However, the insurer must prove the misrepresentation was material and relied upon when issuing the policy.
What is the burden of proof for policy voidance?
The insurer bears the burden of proving that the misrepresentation was material — meaning it would have influenced the insurer's decision to issue the policy or set the premium. Courts apply an objective test, asking whether a reasonable insurer would have acted differently. The insured's intent to deceive is not required.
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About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a material misrepresentation - procurement of insurance policy matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.