The Insurance Ombudsman (IFSO) has helped settle a claim from the wife of the insured following his death from cancer at 31 years of age.

The insurer had originally declined the claim as it alleged he had failed to disclose a colonoscopy when he was 13 and anaemia in 2013.

As he was only 13 at the time of the colonoscopy the insured had only a limited memory of the procedure and believed he was told there was nothing to worry about.  IFSO found that there was no clear diagnosis of any bowel disease, so he had not failed to disclose such illness.

In relation to the anaemia this would have resulted in different terms being offered if the insurer had known about it.  IFSO negotiated for the insurer to pay out on what the terms would have been and so the deceased’s wife received a pay out of half the life cover ($95,000).

You must disclose all relevant medical history and a failure to do so could mean you (or your loved ones) do not get the cover you have been paying for.  If in doubt disclose, as this puts the onus on the insurer to decide on what basis they will offer insurance.

 

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Alan Knowsley