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No-Fault Insurance Law

Fraudulent Procurement

Procurement misrepresentation requires claim-specific denial timing and proof of materiality. The archive separates those defenses from retroactive rescission and out-of-state policy disputes.

14 articles from 2015–2020 · 5 current · 5 reviewed case notes · by Jason Tenenbaum

Current articles

Articles the firm treats as current: published since 2024, or older and re-checked against today's law. Most recently published or reviewed first.

How the firm handles these matters

Reviewed case notes by year

Notes on decisions from earlier years that the firm has re-read against current law. Each note states when it was last reviewed and what has changed since.

Older archive

Case notes as they were written at the time. They have not been re-checked against later decisions, so treat them as history and confirm the current rule before relying on one.

Frequently asked questions

What constitutes a material misrepresentation that voids an insurance policy?

A representation is a statement of past or present fact made to the insurer, by or for the applicant, at or before the making of the contract as an inducement to it; a misrepresentation is a false one (Insurance Law § 3105(a)). It avoids the contract or defeats recovery only if material, and it is material only if knowledge of the true facts would have led the insurer to refuse to make the contract (Insurance Law § 3105(b)(1)). The insurer's practice in accepting or rejecting similar risks is admissible on materiality (Insurance Law § 3105(c)). Common examples: a false garaging address, undisclosed household drivers, the vehicle's true use.

Can an insurer void a no-fault policy retroactively?

For a New York auto policy, the Second Department has said no. Vehicle and Traffic Law § 313 supplants the insurer's common-law right to cancel retroactively for fraud or misrepresentation and allows cancellation only prospectively, so the policy stays in force for innocent third parties injured in the accident (Insurance Co. of N. Am. v Kaplun, 274 AD2d 293 (2d Dept 2000)). The insurer may still deny benefits to the insured who participated in the fraud and sue that insured to recover what it paid others (Kaplun). The misrepresentation must be material under Insurance Law § 3105(b)(1). Policies issued in other states may be governed by those states' rules.

What is the burden of proof for policy voidance?

The insurer proves both the misrepresentation and its materiality. The statutory test: no misrepresentation is material unless knowledge by the insurer of the facts misrepresented would have led it to refuse to make the contract (Insurance Law § 3105(b)(1)). Evidence of the insurer's practice in accepting or rejecting similar risks is admissible (Insurance Law § 3105(c)), so underwriting guidelines are the usual proof. The statute requires intent only for health-expense policies (Insurance Law § 3105(b)(2)). A proven misrepresentation still does not permit retroactive cancellation of a New York auto policy against innocent third parties (Insurance Co. of N. Am. v Kaplun, 274 AD2d 293 (2d Dept 2000)).

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