When you complete an application for insurance you will be asked questions relating to the risk that you’re asking to be insured against. That only makes good sense really, doesn’t it? You will be asked to disclose any material fact that could affect the risk that you’re asking the insurer to cover.
This is based on the long-established principle of English law that the contract between insurer and insured is one based on the principle of something called uberrimae fidae, which is a Latin expression meaning “uttermost good faith”. Under this principle, the insured must disclose to the insurer any matter that may possibly affect the risk of loss. Moreover, that obligation extends to all material information – whether asked for or not.
This puts the onus on you, as the insured person, to disclose to an insurer anything at all that could affect the risk you’re asking him to insure against. Even more critically, any non-disclosure by you of any material information or fact can allow the insurer to declare the contract null and void in law. In that case, nothing is paid out in the event of a claim under the policy you thought you had.
As you can readily appreciate, this principle has a pretty significant bearing on any life insurance policy you might want to take out. What are the 'material facts' that might possibly affect the risk of you dying within the term of the proposed life cover? What are the material facts from your medical history or from your lifestyle choices? It’s difficult, isn’t it? Especially when you remember that the onus is on you to decide what is material, whether the insurer asks a specific question about it or not.
The question gets even more complicated when you’re also thinking of taking out critical illness insurance. Just how much of your medical history and how much of your lifestyle should you disclose? The insurer certainly won’t go through the expense of scouring your medical records for you (though he will probably ask for access to those records should the need arise at some future date). The burden is on you and non-disclosure of anything that the insurer later determines to be a material fact might be enough to enable him to reject a claim under the policy.
Five things to remember
Whenever you’re completing a proposal for life insurance or critical illness cover, there are certain questions which demand particular attention. Indeed, there are identifiable questions which insurers themselves have complained that people too often fail to address. The following are the five principal conditions that insurance companies have identified as being insufficiently disclosed by people seeking life insurance or critical illness cover:
- Treatment (which will include tests and investigations) for multiple sclerosis, affected vision, numbness or disorientation;
- Any current medication or treatment (or tests and investigations which might lead to medication or treatment);
- Whether or not you are a smoker or drinker of alcohol, and whether you have been advised to reduce your use of either tobacco or alcohol;
- Whether you have suffered any depressive illness; and
- Whether you have received any medical treatment at all during the past year.
If a claim is rejected because of a non-disclosure, the usual recourse of insurance companies is to return to the customer all premiums that have been paid and so put both the insurers and the customer in the same position as they were before the insurance policy was issued. However this will be precious little comfort to you, the intended insured, because by then it will be too late.
- The onus of disclosure is on you, the policy holder;
- Material facts and information must be disclosed, whether or not the insurer specifically asks about them;
- Failure to disclose any material fact or information can invalidate the policy and lead to claims under it being rejected by the insurer.