Imagine if you are enjoying a holiday but then slip and break your leg, only your insurer won’t pay for you to get back home because you didn’t disclose you’re taking a small amount of medication for depression. Or a trip to A&E in America leads to a massive bill because your insurer has concluded you have a ‘history’ of alcohol abuse.
These cases do sometimes occur because of ‘non-disclosure’ and it’s one of the most contentious areas of complaint that I see.
Most insurance policies will require you to disclose key information that might affect the premiums you pay, or if you are offered insurance at all. Some of the most heart-breaking insurance problems I’m asked to sort out involve non-disclosure of medical conditions.
It goes without saying that I tend see the worst examples – and the majority of claims go through without a hitch. But what do you need to disclose when taking out insurance?
Non-disclosure and applying for insurance
Back in 2012, the law around disclosure changed for the better. You have to tell the insurer about things that could affect how much you pay for the policy. But they also have to ask you clear questions so you know what to disclose.
These days, most people buy insurance policies online, which means it’s easy to click through a long list of ailments without thinking if all of them could potentially apply to your circumstances. So you might click a box to say that you haven’t had a stroke, but you might not mention that you’ve been to the doctor about pins and needless or numbness – which could be a warning sign of a mini-stroke (or lots of other conditions). The key factor here is whether your doctor was sufficiently concerned to order further tests or diagnose a condition.
All insurance policies are different – and travel insurance in particular varies considerably, so there’s no standard guide to on what people need to disclosure. In fact, some insurers might cover some things that others don’t. Which? has a fantastic guide to the main conditions you need to report – regardless of whether you have been diagnosed or if your doctor is arranging tests to see if you to see if you do.
When it comes to what you must disclose, in very general terms, you need to tell the insurer:
- If you’ve had a serious condition, even if it’s in remission.
- If you’re waiting for an operation or have had one over the last few years.
- If you’re waiting for test results, from blood tests to x-rays or are being tested for something.
- If you have an ongoing condition that you are receiving treatment for.
Then things get complicated. Some insurers ask you disclose every trip to the doctors you’ve had over the last year or two. Others, just ones where you had treatment or tests.
Insurers also need to make you aware of ‘key facts’. These are things that are essential parts of the policy and the agreement you sign. You’ll get a key facts leaflet or link to a download when you take out a policy. This should contain all of the main information you need to know about your policy, like maximum payment limits, what you have to do if a ‘claimable’ incident occurs or the excess fees for different types of claim. Insurers should also highlight vital T&Cs – for example, notifying them of every recent doctor’s appointment if that’s what they require. You can’t make an informed decision unless you are fully aware of this.
Insurance is vital in so many parts of our lives. It gives us a sense of assurance that if something unexpected goes wrong, we will be protected. But like any agreement, we have to provide all the relevant facts – and insurers need to play fair and ask us all the right questions.
Martyn James is a leading consumer rights campaigner, TV and radio broadcaster and journalist.