General Insurance PrinciplesQuestion 299 of 716

On an insurance application, the applicant fails to disclose a serious heart condition that he knows about and that materially affects the risk. The insurer issues a life policy. Which California Insurance Code concept BEST describes this conduct?

a.Warranty — a stated promise that a fact is true and will remain true throughout the policy term, and its breach is the only ground on which a California insurer may rescind a life insurance policy
b.Representation — an oral or written statement of a fact made to induce the insurer to enter the contract; a failure to speak about a known condition is itself treated as a representation, and only material misrepresentations permit rescission
c.Adhesion — the applicant merely adhered to the insurer's pre-printed form, so any nondisclosure is construed against the insurer that drafted the application and the policy stands as written
d.Concealment — neglect to communicate something the applicant knows and ought to communicate; even unintentional concealment of a material fact entitles the insurer to rescind under California Insurance Code §330-§339

Explanation

California Insurance Code §330 defines CONCEALMENT as 'neglect to communicate that which a party knows, and ought to communicate,' which is exactly the applicant's silence about a known heart condition, so the concealment response is correct. Under §331, 'Concealment, whether intentional or unintentional, entitles the injured party to rescind insurance' — a strict standard reflecting that materially silent applicants undermine the insurer's risk assessment in a contract of utmost good faith, and §330-§339 supply that rule. WARRANTY (§440 et seq.) is a stated promise within the contract; breach also permits rescission but warranties are rarer in modern policies, so the warranty response misses that warranties are explicit contract promises and is not the sole ground for rescinding a life policy. REPRESENTATION (§350-§360) is an inducing statement and only MATERIAL misrepresentations support rescission, so that response does not capture a failure to speak. ADHESION is a contract-formation doctrine, not a disclosure rule, so that response is off-topic. The hallmark of concealment is silence about a known, material fact.

Law Reference: California Insurance Code §330-359 (concealment, misrepresentation, warranties)

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Reviewed by John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — verify)
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