Merritt Personal Lines Manual: Requiring Physical Exams

Physical Examination: During the pendency of a claim, we will have the right and opportunity, at our own expense, to examine an insured person as often as we may reasonably require.

While a claim is being verified, the insurance company has the right (at its own expense) to examine an injured claimant. This item only comes up in rare cases in which an insurance company suspects significant fraud.

Misstatement of Age: If the age of an insured person has been misstated, all amounts payable under this policy shall be such as the premium would have bought at the correct age.

If an insured person's age has been misstated in the application, any benefits payable will be adjusted to the amount that the premium would have purchased at the correct age. This item usually governs situations in which older policyholders lie about their age in order to get cheaper premiums. If the insurance companies discovers this, it will prorate any coverage down -- and probably not renew the policy.