FANews
FANews
RELATED CATEGORIES
Category Life Insurance

Liberty encourages full disclosure to avoid repudiation at claim stage

24 May 2019 Liberty

The number of repudiated claims due to non-disclosure improved significantly from 2017 according to Liberty Claim Statistics for 2018. However, there's still work to be done in encouraging policyholders and potential customers to disclose all information when taking up insurance cover.

When looking across all benefits of all claims received by Liberty in 2017:
• 8.6% of submitted claims were for conditions that did not meet claims requirements
• 1.6% of claims were declined due to non-disclosure and fraudulent claims

When looking across all benefits of all claims received by Liberty in 2018:
• 4.7% of submitted claims were conditions that did not meet claims requirements
• Only 0.66% of claims were declined due to non-disclosure and fraudulent claims

Lisa Gibbon, Divisional Executive for Onboarding at Liberty says, "At Liberty, we've placed a strong emphasis on ensuring that advisers and clients focus on providing true and accurate information during the underwriting process. We've also been encouraging advisers and clients to continuously keep us informed of any life changing medical and lifestyle changes that would impact their policies."

The importance of full-disclosure should be a priority conversation that all insurers should be having with their clients and advisers as often as possible. Not only will it help to reduce the occurrence of non-disclosure claims, it will also ensure that clients receive their pay-outs when they need it most.

Gibbon explains, "As an insurer, we have a responsibility to ensure that all valid claims are paid. However, we also encourage clients to submit claims even if they are uncertain of the severity of their condition or if the condition is covered under their policy benefits."

What is non-disclosure?

When medical, financial, lifestyle or occupational questions are answered incorrectly or when important information is omitted during underwriting, this is called non-disclosure. If your financial adviser fills in the insurance application form out for you, it is your responsibility to read through everything carefully before signing.

Prepare for the underwriting process

The underwriting process; though it may seem intrusive, is important. It requires the client to be prepared to answer any questions that need to be discussed. So before the process starts, clients should consider preparing some of the following information:

• Your health history, including any hereditary diseases or health challenges in your family tree.
• Your financial information such as your monthly income, savings and other.
• Your lifestyle practices, like smoking or alcohol consumption.

"Even if you think certain information is unnecessary, disclose it anyway," says Gibbon.

Elements like sending a nurse to the client for the relevant blood tests required or providing tele-underwriting services for those clients who prefer to speak directly to the insurer about their personal finances and medical conditions are some processes that insurers have put in place for ease of underwriting for clients. Liberty pioneered nurses-on-the-road and finger prick testing for its clients to make the process of underwriting easier.

Quick Polls

QUESTION

In terms of vicarious liability, damages should not be borne by companies in all conditions, but only in those circumstances which it is reasonable for them to do so. Do you agree?

ANSWER

Yes, damages should only be borne by companies in those circumstances which it is reasonable for them to do so.
No. If there is a sufficiently close link between the employee’s acts and the purposes and business of the employer, the employer should be held liable for delicts committed by their employees.
As long as the employee is acting within the course and scope of his or her duty… the employer will be held liable.
A E fanews magazine
FAnews October 2019 Get the latest issue of FAnews

This month's headlines

Non-disclosure - a question of fairness
Level of insurance regulation notably tightened
The cost of treating cancer
Employee Benefits… an untapped opportunity
Bound to NHI… whether you like it or not
A stormier world for marine insurers
Examining the application of reinstatement clauses
Subscribe now