Insurance Agent Misrepresents Policy

Stephen Gomez

Written by
— Updated on October 2, 2017

This case involves a misrepresentation by an insurance agent. The plaintiff took out an insurance policy on his automobile. The policy covered a number of situations, but there was a question as to whether the policy covered flood damage. The plaintiff called the auto insurance agency to discuss and understand the items covered by his policy. The plaintiff specifically asked the agent if flood damage was covered by the policy.The agent said that she had checked with her supervisor and that flood damage was covered by the policy. Two weeks after Hurricane Sandy had damaged the plaintiff’s automobile, he filed a claim with the insurance company. The insurance company, however, claimed that the policy did not cover flood damage.

Question(s) For Expert Witness

  • 1. If an insurance agent represents a policy as covering a specific item, is that item covered?

Expert Witness Response E-001255

This involves different questions of agency and insurance law. Specifically, this covers a disparity between the language in a policy and the representations made to an insured party. In this case, with the agent working at the insurance agency, serving as an agent, it appears that they were qualified to represent the policy of the insurance company. Furthermore, when there are a number of different items covered, insurance agents are expected to clearly state what is covered and what is not covered. Then, the insured party can make an accurate decision regarding whether further coverage is required. Because of this, the insurance company is probably responsible for providing flood damage coverage to the plaintiff. I have over twenty-nine years experience working in the insurance industry, both as an agent and a policy designer.

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