When a life insurance claim is denied in Ontario, insurers often point to one issue:

Misrepresentation in the application.

For many beneficiaries, that sounds final.

If something was wrong or incomplete in the application, the insurer must be entitled to deny the claim—right?

Not necessarily.

At Mulqueen Disability Law, we regularly see life insurance claims denied on this basis where the legal test has not actually been met.

What Is a Misrepresentation in Life Insurance?

A misrepresentation is an incorrect or incomplete statement made during the application process.

This often relates to:

• Medical history
• Smoking status
• Prior diagnoses or symptoms

However, not every incorrect answer is legally significant.

The Key Legal Test: Materiality

The central issue is whether the alleged misrepresentation was material.

In simple terms:

Would the insurer have issued the policy if it had known the full information?

If the answer is yes, the misrepresentation may not be material.

If the answer is no, the insurer may have grounds to deny the claim.

But the key point is this:

The insurer must prove materiality.

Courts Do Not Accept Every Misrepresentation

Courts in Ontario have made it clear that:

• Not every inaccuracy justifies voiding a policy
• The insurer bears the burden of proof
• The analysis must be grounded in evidence, not assumptions

This is particularly important in life insurance cases, where applications are often completed quickly and without full appreciation of what may later be considered significant.

The Role of the Two-Year Incontestability Period

The analysis becomes even more important once the policy has been in place for more than two years.

After that point:

• The insurer’s ability to rely on misrepresentation is limited
• The threshold for denying a claim becomes higher
• Fraud may need to be established

For a detailed discussion of this issue, see:
👉 Denied life insurance claim after two years

Why These Cases Are Often Misunderstood

Many beneficiaries assume that if the insurer identifies an error, the claim is lost.

But that is not how courts approach these cases.

Instead, they ask:

• Was the question clear?
• Did the insured understand what was being asked?
• Was the information actually material?
• Is there any evidence of intent to mislead?

In many cases, these questions do not favour the insurer.

The Reality: These Cases Are Highly Fact-Specific

Life insurance misrepresentation cases are rarely straightforward.

They often involve:

• Complex medical histories
• Ambiguous application questions
• Missing context
• Retrospective analysis by insurers

When examined closely, many denials are open to challenge.

What You Should Do If Your Claim Was Denied

If your life insurance claim has been denied for misrepresentation, you should take the time to understand the basis of the decision.

Request the application, review the questions, and consider whether the alleged issue was truly material.

Most importantly:

Do not assume that the insurer’s conclusion is correct.

Speak With a Lawyer About a Denied Life Insurance Claim

At Mulqueen Disability Law, we help clients challenge denied life insurance claims in Ontario.

We assess whether insurers have met the legal test for misrepresentation and take steps to recover benefits where appropriate.

Further Information

To better understand life insurance claims and related legal issues:

• Financial Consumer Agency of Canada – Insurance basics
• Denied life insurance claims after two years (incontestability):
• Long-term disability and insurance claims:

Disclaimer

This article is for general informational purposes only and does not constitute legal advice. Life insurance claims involving misrepresentation are highly fact-specific. You should seek legal advice tailored to your individual circumstances.

Frequently Asked Questions

What is a misrepresentation in life insurance?
It is an incorrect or incomplete statement made during the application process.

Does any misrepresentation void a policy?
No. The insurer must prove that the misrepresentation was material to the risk.

Who has to prove materiality?
The insurer bears the burden of proof.

What if the question on the application was unclear?
That can be important. Courts consider how the question was asked and what the applicant reasonably understood.

What should I do if my claim was denied for misrepresentation?
Request the application and supporting documents and have the denial reviewed before accepting it.