What is a material fact in an insurance contract?


vector image of people holding insurance papers - material fact in an insurance contract

“A material fact under the insurance contract is any situation or information which can increase the frequency and/or severity of a loss which is covered under that particular insurance contract.”

Any fact that has relevance to the risk in question is a material fact and is used by the insurer to assess the risk before awarding the insurance contract.

For example:

A dog bite could be a material fact for a health insurance contract which has to be declared by the proposer to the insurance company. But this is not a material fact in the case of buying home insurance.

An insurance contract works on the principle of utmost good faith. This means that both parties to the contract, viz. The insurer and the proposer have a duty to disclose all material facts before the commencement of the contract.

Any misrepresentation or non-disclosure of material facts is considered a violation and could lead to rejection of the claim and even termination of the contract.

It’s always advisable to take the help of insurance brokers to avoid anything that can disqualify your claim in the future. The good news is, it will not cost you anything.

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Susheel Agarwal

Susheel is the CEO of Ethika Insurance Broking P Ltd. This company, which has a current value of 10 million dollars, was bootstrapped by him and two of his friends. He attributes his success to his ability to inspire others to seek happiness at work.