California Property & Casualty Broker-AgentGeneral InsuranceMedium

A producer is explaining the concept of 'materiality' in insurance to a client. Which of the following statements best describes a material fact?

  1. AA fact that is always considered fraudulent if misrepresented by the applicant.
  2. BA fact that is important to the insured, even if it doesn't affect the insurer's risk assessment.
  3. CA fact that, if known, would have caused the insurer to decline the policy or charge a different premium.
  4. DA fact that is recorded in the application, regardless of its impact on the insurer's decision.
Show answer & explanation

Correct answer: C. A fact that, if known, would have caused the insurer to decline the policy or charge a different premium.

A material fact is any information that is crucial to the insurer's decision-making process regarding the acceptance of risk or the premium to be charged. Its disclosure would alter the insurer's underwriting decision.

Why the other options are wrong

  • A. While misrepresentation of a material fact can be fraudulent, not all material facts are automatically fraudulent if misrepresented; it depends on intent.
  • B. Materiality is determined from the insurer's perspective, not solely the insured's.
  • D. Simply being recorded does not make a fact material; its impact on the decision does.

Material Fact

In insurance, a fact is considered material if its disclosure would influence a prudent insurer's decision regarding whether to accept the risk or the terms and premium to charge.

  • Crucial for underwriting decisions.
  • Non-disclosure or misrepresentation of a material fact can void a policy.
  • Determined from the insurer's perspective.

Memory trick: Material facts MATTER to the insurer's mind.

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