The information you provide on the application will form the basis on which the contract of insurance is issued. It is therefore extremely important that the information you provide is truthful, complete and correct. The consequences of not providing information that is truthful, complete and correct are potentially very serious.
What you need to tell your insurer?
What you must tell the insurer depends on the kind of insurance you are arranging. Insurance companies ask a range of questions on application forms to obtain the information they need.
Legally, you must tell your insurer about anything that could affect its decision to insure you or the terms and conditions you will be offered. For example, the information you provide could affect the level of premium or excess, any exclusions or stand-down periods, or if it will insure you at all.
If you can’t remember your full medical history, ask your doctor for a copy of your medical notes, and double-check your insurance application.
It is better to provide more information than is required and let the insurer decide what is relevant. Ask us if you are unsure of anything.
Why do you need to tell your insurer?
You have a legal duty or responsibility to give the company all the information it needs to make a decision on the terms it can offer you insurance. You have a duty to give this information freely, rather than the company having to specifically ask you for it. This is referred to as your ‘duty of disclosure’.
If you do not give your insurer all the information that could affect their decision about the terms and conditions of cover you could be offered, your policy might be avoided when you make a claim.
This means your policy can then be treated as though it never existed (it has been “avoided’) and your insurer can refuse to consider your claim. Even if you left out the information on the application unintentionally, the insurer can still avoid your policy.
If your policy is avoided, it can affect other claims you might have made under the policy, and the success of future insurance applications. This is why it is so important to give the company all the information it requires.
When do you need to give your insurer this information?
You must give the company all the information it requires when you take out the policy, and every time you seek to increase, change, or add additional covers. For house, contents and car insurance this is every time the policy is renewed (usually every year).
Life insurance, income protection, trauma, disability and health insurance policies also require you to tell the company about anything that may happen between completing your application and the insurance cover starting.
This means if you visit the doctor, develop a health problem; have a change in financial circumstances, or your situation changes in some other way between completing the application and your insurance cover starting you must tell the company.
But what if I just forgot or didn’t leave out the information on purpose?
Generally, the current law does not make a distinction between innocent or deliberate non-disclosure. This means that, even if you left out the information on the application by accident or unintentionally, the company can still decline your claim, make changes to your policy, or avoid your policy. It is better to provide more information than is required and let the insurer decide what is relevant.
What happens if I gave my insurance adviser the information, but it wasn’t written on the application form?
The company can avoid the policy and decline to consider the claim. This is because, even when your adviser writes the answers on the application on your behalf, you are still expected to read the answers and sign a statement declaring all the information is correct.
Due to the serious consequences of non-disclosure, it is really important when someone else completes the application for you, that you check to see the answers are correct and no information has been left out.
Why has the company only raised this as an issue now, when I have made a claim?
Insurance companies may only request information from your doctor relating to the medical conditions disclosed on your application form.
Most commonly the insurance company will only find out that you did not give all the information it required, when you come to make a claim. That is when the company asks you more questions or checks up on your history. This can lead to the company finding out about information it should have been given when you applied for insurance.
This information may not be related to the claim you are making but is considered material as the company may have altered the terms of the cover it offered you when the insurance was arranged if they had known about the information.
Can the company decline my claim if I gave them information which wasn’t true when I made my claim?
Yes, a policy will state that you must not give incorrect or false information when making a claim. If you do, depending on the wording of the policy, the company may decline your claim or even cancel your policy. In some cases, they may initiate legal or criminal proceedings. This can also affect any future insurance applications you may wish to make.
The consequences of making false statements to
the company when you make a claim are very serious, so you must be sure all
the information you give to the company is truthful and correct.
Can the company make me pay back the money it paid on a previous claim, if it found out I didn’t give it information when I took out the insurance?
Yes, the company is entitled to recover the amount paid because, by avoiding the policy from its commencement, it is treating the policy as though it never existed.
How can I make sure my insurance policy is not avoided?
The only way you can make sure that your policy will not be avoided is to give the company all the information it needs when you take out the insurance. If you have not given the company all the information you should have, you should tell the company immediately. Remember, most insurance companies do not cover pre-existing conditions.
What is a pre-existing condition?
There are many different definitions for pre-existing conditions. Some policies may define them as any medical condition traceable to a condition you had before taking out the policy, even if you did not know you had it. Others will define them as conditions you knew you had before taking out your insurance.
However, this definition will depend on the particular company, as some will, after time, cover certain pre-existing conditions as a loyalty benefit. It is also worth remembering that if you suffer an injury or sickness, or develop a condition while you have insurance cover and you subsequently change to a new company, it is likely this will be treated as a pre-existing condition and no cover will be provided for it.
Is it fair that my insurance does not provide cover for pre-existing conditions?
Unless your policy offers you cover for pre-existing conditions, the company is not obliged to cover them. Generally, companies specifically exclude cover for pre-existing conditions or any associated treatment, because pre-exiting conditions pose a higher risk to the company and the greater likelihood of a claim.
Important information for house, contents, car and travel insurance
Information relating to you, e.g. your insurance history / any claims made, any criminal or traffic convictions you have, if you have been bankrupt; and
Information relating to your vehicle or property e.g. if you have tenants living in your house, if your car has been modified, if you live on a flood plain, any security systems or alarms you have.
Information relating to any pre-existing medical conditions that you have for travel insurance. You may have to pay an additional premium to have cover for your pre-existing medical conditions