When is a misrepresentation on an insurance application considered fraud?

A misrepresentation on an insurance application is considered fraud when it is intentional and material. Intentional means that the individual knowingly provided false information, aiming to deceive the insurance company. Materiality refers to whether the misrepresentation could influence the insurer's decision to underwrite the policy or determine the premium. For example, if an applicant intentionally misstates a critical health condition on the application, that information is material because it could significantly affect the risk assessment and pricing by the insurance company. This standard is essential for maintaining the integrity of the insurance process, ensuring that all parties are transparent and making informed decisions based on accurate information.