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Phantom of the Opera

Insurers are sometimes encouraged to refuse claims when an insured gives false answers to an investigator.  Great care needs to be taken to look at the answers in the context of all the evidence.  Proving that the answers are false is not sufficient.  It has to be proved that the answers are knowingly false and made to induce payment.  This is not an easy burden.  The insurer need to ask itself, among other things: are the answers in fact false;  is there an interpretation to the answers which may favour the insured;  even if the answer is false, could the insured be given the benefit of the doubt by finding that the insured was merely mistaken;  has the insured otherwise acted in a fashion more consistent with honesty (e.g. as in the following case, giving the insurer, by means of authorities etc, access to the accurate information despite the insured’s answer being wrong).

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