2308. Affirmative Defense Misrepresentation or Concealment in Insurance Application Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
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2308. Affirmative Defense?Misrepresentation or Concealment in Insurance Application Instruction No 1 Request by Plaintiff Request by Defendant Requested by Given as Proposed Given as Modified Given on Court?s Motion Refused Withdrawn Judge Instruction No 1 [Name of insurer] claims that no insurance contract was created because [name of insured] [concealed an important fact/made a false representation] in [his/her/its] application for insurance. To establish this defense, [name of insurer] must prove all of the following: 1. That [name of insured] submitted an application for insurance with [name of insurer]; 2. That in the application for insurance [name of insured], whether intentionally or unintentionally, [failed to state/represented] that [insert omission or alleged misrepresentation]; 3. [That the application asked for that information;] 4. That [name of insured] knew that [specify facts that were misrepresented or omitted]; and 5. That [name of insurer] would not have issued the insurance policy if [name of insured] had stated the true facts in the application. New September 2003; Revised April 2004, October 2004, June 2015