When it comes to insurance, ‘full medical disclosure’ can make or break a claim. Disclosure requirements are commonly misunderstood and one of the leading reasons why insurance claims are denied. Our Global Finance expert insurance brokers are here to help you understand the seriousness of the questions being asked – and make sure you don’t miss anything.
Nothing but the truth
Insurance companies need to gather all relevant information to determine the risks involved in insuring your life, income and medical. This includes medical conditions, hospital stays, surgeries, test reports, any current medication or treatment plans, historical health issues and doctor visits. Sharing this information is how they calculate your premium and policy conditions – and it safeguards you from the chance of any future claims being denied.
While it’s an insurance provider’s responsibility to ask the relevant questions, it’s your duty to take reasonable care by being truthful and upfront when answering them. It’s also your responsibility to keep your insurer updated with any changes that may affect your policy, for example:
• Behavioural changes, e.g. taking up smoking or other life-threatening activities
• Medical developments, e.g. cancer or terminal sickness
The consequence of withholding
Consider this – you need knee surgery so you apply for the cost to be covered by your medical insurance. You haven’t made any claims over the past four years, but the insurance company assesses your claim and finds a doctor’s report of a minor injury you sustained ten years ago and didn’t disclose. Your claim is rejected on the grounds of non-disclosure of pre-existing medical conditions, leaving you to foot the bill.
Another example – your spouse passes away from a terminal illness, and your life insurance providers find several doctor’s visits for headaches before the diagnosis. They suggest you knew about the severity of the illness before you purchased the insurance – and stall your pay-out while they investigate further.
New Zealand insurers have a good reputation for being lenient with honest mistakes. But it’s worth remembering that failure to disclose any relevant information on your insurance application gives the insurer the right to:
1. Decline any claim you make
2. Void your policy
3. Ask for reimbursement for any benefits already paid
4. Alter the terms of your policy
Tips for ensuring full disclosure
The Insurance and Lending Group in New Zealand reported 272 complaints regarding insurance policies within a single year, and 11% were regarding non-disclosure.
A statement made by New Zealand’s Citizens Advice Bureau said, “Many people have not understood what the duty of disclosure actually means, neglect to meet these requirements and then feel aggrieved when a claim is declined as a consequence.”
To make sure you’re in the best position when buying your insurance, here are some recommendations:
1. Get a check-up – before taking out any insurance, visit your doctor to get a complete medical history.
2. Be open – be forthcoming with your information and let your provider decide the relevance of it. This way you won’t accidentally miss something they deem to be important.
We’re here to help
Without guidance, it’s easy to forget certain details or overlook things that seem insignificant when filling in insurance forms. That’s why having an expert in your corner can make all the difference. Global Finance’s insurance experts are with you all the way to see that your policy is filed correctly. We will ensure you have the correct cover, so when it’s time to make a claim, your risk of being denied is low.
Call our team at Global Finance today to discuss any new or existing personal insurance policies.
**Underwriting criteria and insurer terms T’s and C’s apply