Question
What is the name of your state? IN
Someone asked me about Life Insurance for Man having a sex change into a woman. Does that change the premium? What documentation do I need to substantiate the gender of an individual? If a person presented themselves to me as one gender, later in life had a sex change and subsequently died as another gender, would an insurance company consider that fraud? If a person is sitting in front of me self-identifying as female but I suspect this person is actually male, what burden of proof must I have? I know this sounds a little wacky but these are real life situations! Thanks. john
Answer
First of all, the life insurance rates are generally different for male and female, and other underwriting considerations may be at issue as well.
Typically, if, within two years, the insurance company discovers an application misstatement that is "material to the risk (the policy would not have been issued as applied for), they have the right to rescind coverage and refund all premiums paid.
Most states also allow for rescission of coverage after two years on the basis that the misstatements were made fraudulently if (1) allowed in the states' insurance laws, and (2) if this is stated in the policy.
Fraud.....hmmmm.... was the misstatement made with the intent to deceive coupled with knowledge that the insurance company could be harmed or placed in a disadvantageous position, or because the applicant was embarrased....sounds like a jury question to me.
We are not attorneys and do not give legal advice or legal opinions. Any opinions or comments in our response should not be regarded as a substitute for professional legal advice.
Answer
Thanks for your very thoughtful reply. I guess I still wonder, if a person secures a life insurance policy and is male at the time the policy is isssued, and over the course of time elects to gender reassignment to female, that person made no misstatement to the company. A critical determinant changed but not as a result of misstatement or fraud.
I guess what I hear you saying is, this is uncharted territory and may have to be explored through case law? If you could point me toward any additional resources, I'd appreciate it.
Thanks again. john
Answer
No misstatement.....no basis for rescission. I don't see a problem, with the exception of some possible confusion and additional proof being required in the event of a loss.