Can I be denied PIP for failing to list a household resident on my insurance application?

April 20, 2016

Sadly, the answer is yes, you may be denied PIP coverage for failing to list a household resident on your application for auto insurance. When you apply for auto insurance, the application typically asks in one form or another that you list all residents in your household. Your insurer may deny PIP coverage if you did not tell the insurer about all of the people who resided with you at the time your application was completed.

The leading Florida case addressing this issue is United Automobile Insurance Company (“United”) vs. Salgado. In this case, the application asked Salgado to list all residents in his household who are fourteen (14) years or older. Salgado completed the application and a policy was issued by United.

During the effective period of his insurance policy, Salgado was injured in an automobile accident. After receiving medical treatment for his injuries, his bills were submitted by his medical providers for reimbursement under Salgado’s PIP coverage. After completing an investigation, United determined that Salgado had failed to list his brother as a member of the household on his application and notified Salgado that due to the material misrepresentation, his policy was cancelled as of its effective date.

Salgado sued his own insurance company in an attempt to compel them to cover him under his Personal Injury Protection (“PIP”) insurance coverage. United responded by taking the position that Salgado’s failure to list his brother as a member of his household on his insurance application constituted a material misrepresentation since the unknown risk would have resulted in a higher insurance premium. United won, and did not have to extend PIP benefits to Salgado.

There are a few crucial takeaways from the Salgado case:
1. Even if a household member is not old enough to drive you must list them on your application.

2. Even if a household member does not have a driver’s license, you must list them on your application.

3. Even if a household member is not a relative, or just a roommate, you must list them on your application.

Not every Florida Insurer will make an issue out of failing to list a household resident, but many of the “nonstandard” auto insurers will. Not all misrepresentations are sufficient to support a denial of coverage and you may have a defense available if this issue is raised by your insurance company.

Bottom Line: When applying for auto insurance, answer every question on the application as honest as possible. If you fail to do so, your insurance carrier may attempt to deny you PIP benefits or other important coverages in the event of an accident.

For more information concerning PIP automobile insurance coverage, please feel free to call us at (813) 991-5099. We are standing by to help every day, all day.

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