Life Life Insurance and Full Disclosure

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marathonic

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Okay, I'm probably one of the most paranoid people around when it comes to worrying about possible non-payment of insurance policies due to non-disclosure.

So my query is as follows:

  • I apply for life insurance and answer all questions to the best of my knowledge
  • The insurance company orders a medical report
  • I'm subsequently accepted and granted a policy
  • Something that I said in my original application is proven wrong via my medical records (possibly a part of them that the wasn't anything to do with the reason the insurance company originally requested the medical report)

What happens in the above scenario or is it even possible (I'd assume that, when a medical is ordered, they go through it with a fine tooth comb)?

Let's take it to the extreme and say that it was a HIGHLY relevant question that you answered incorrectly - not something like "have you ever had cancer" but something easier to forget about like a "family history" question (not sure if this would even be included in my own report but you get what I'm trying to say).

If your answer was proven wrong by a medical report that they ordered and they grant you a policy, can that medical report subsequently be used for non-payment of a claim.

After reading the above post, refer back to the first sentence and you'll see what I mean :)
 
Generally if insurance companies receive an application that has a medical disclosure on it, they will request a PMAR (medical questionnaire from your GP) & only a medical if something comes back on the PMAR that they're not happy with. These are usually fairly generic and may not go in to a lot of detail about family history. So answer to your question would be, you may not be overly paranoid. If you did not disclose full family history on your application as asked, then your policy maybe invalidated. I would contact the company and make sure they know all the facts. If they agree to keep you on cover, get a letter from them confirming same.
 
Sumatra said:
Hi marathonic, Did you keep a copy of the application form for your own records?
Click to expand...

I did.

This is all hypothetical. There isn't anything I'm aware of that I haven't disclosed (unless of course, my parents had an illness that they didn't want to worry me about or something).
 
Read the declaration you signed and with this in mind check the answers you gave to the medical questions. If you are happy then no further action is required. If you feel you need to correct an answer then write to the insurer quoting your policy number.
 
Material facts ! You must disclose everything that is relevant even if you dont think it is relevant. The company will decide if it is material or not.
 
Normally claims are settled quickly but in the event of a dispute there is still nothing stopping the claimant taking the insurer to court or arbitration. In the past disputes arose because of ambiguity in the questions asked on the proposal which in turn lead to a poor response (if any) but improvements in the way questions are worded leaves the applicant in no doubt as to what information the insurer requires which in turn results in very few rejected life assurance claims.
 
The principal of Uberiade fides here is important its mutuality of good faith..yes your supposed to disclose but you can only disclose what you actually know. If you dont know then you should be ok see case law on New Ireland assurance

If you did know and the question is in relation to a family member there is no way they can possibly know or find out since medical records are covered by Data protection act. If they did find out your policy will most likely be void
 
For a death claim the insurer could obtain access to the insureds records as this is covered in the declaration the applicant signs when they are taking out the policy. The duty of disclosure does not only apply at signing of proposal but right up until the first premium has been paid and the policy issued. Duty of disclosure does not apply to use and handling of genetic test information.
 
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