To know or not to know - Insurance Disclosure

An applicant’s medical history makes up an important part of any insurance application. 

As time has progressed the human body has become subject to an ever-increasing number of new medical conditions. To better understand rare or unusual conditions the insurance underwriters have two key places to gain information when assessing an application.  There is the actuary data that has been accumulated over a number of decades and the applicant’s medical notes.

This brings me to two points that I want to alert you to.

Disclosure and Medical notes.

Disclosure is such an important part on any insurance contract whether that be a domestic insurance (house, car, contents) or personal insurance application. 

What does the term ‘Disclosure’ actually mean?

Disclosure places an obligation and duty of care on both of the client and the adviser /intermediary to ensure that any information relevant to an application is not only accurate and truthful, but also information is disclosed even if not specifically asked for. 

Disclosure provides the insurer a fair and reasonable understanding of the risk(s) that they may be taking on.

What are the implications for failing to disclose?

The failure to disclose information or disclosing incorrect information may result in the cancellation of the policy or the declinature of a payment for a claim.

 There is always some ambiguity around disclosure as there are situations where applicants genuinely cannot remember or can’t recall the exact details. 

Central government is aware of the challenges around disclosure and currently changes to the legislation are in progress.

Medical notes

Why have I raised this. As I mentioned earlier an applicant’s medical notes are what insurance underwriters use to know more about a client’s medical history. 

I have a warning for you. Know what has been recorded on your medical notes.

I have had a personal situation where inaccurate information was recorded on my medical notes. If I was applying for some insurance, the inaccuracy may have impacted the insurer’s decision.

You also need to be very aware how you answer questions your doctor may have asked you or general comments you make.  This is particularly important if there is any discussion on any thoughts or feelings relating to mental health.

 The typical question is “have you had any situations where you have felt anxious or depressed”.

OMG, we sold a house late last year, I was very anxious as to whether we would get any tenders.   I hit the worst golf score in my life a few weeks back. I was short term depressed about my game.

You make a comment like that and to cover themselves GP’s will make a comment on your medical notes.

That comment may influence any possible future insurance underwriting resulting in a mental health exclusion on your cover.

I know of a situation recently where an applicant’s questionnaire response was contradictory to what was recorded on the medical notes. Was this inaccurate recording by the GP or practice staff. This of course now creates suspicion of non-disclosure.

Here is my message to you all!

You are entitled by law to know what is written on your medical notes.  If you are seeking insurance cover or you need to increase insurance cover, I implore you all to take the time to check and ensure your medical notes reflect the true context of your health and / or any discussion you may have had with your GP or a Specialist.