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Non disclosure case studies from the Ombudsman

The IFSO (Insurance and Financial Services Ombudsman) regularly provides its members with case studies on actual claims before it.

 

Here are some interesting case notes on real life cases on non disclosure:

Recent non-disclosure cases seen by the IFSO Scheme

Vehicle insurance

http://www.ifso.nz/assets/Uploads/133707-2016.pdf
When Ben bought a car, his finance company arranged the insurance. When the car was later stolen, Ben’s claim was declined and the policy avoided, because Ben hadn’t mentioned his previous criminal convictions. Ben said he wasn’t asked. The only documentary evidence available was the policy schedule, which showed that Ben had answered “no” to the question about whether he had any convictions.

House insurance

http://www.ifso.nz/assets/Uploads/130524-2015.pdf
The Brown’s house was damaged by a fire and Mrs Brown made a claim. During the phone call she mentioned that she’d had a previous contents insurance claim declined by another insurer. The insurer then discovered the Brown’s previous policies had been cancelled. On their insurance application, Mrs Brown had answered “no” to the question about whether they had had any previous declined claims or policies cancelled in the past 5 years.

Trauma insurance

http://www.ifso.nz/assets/Uploads/132910-2016.pdf
After John suffered a stroke, he made a claim under the critical illness benefit of the policy. His claim was declined and the policy avoided, as John had not disclosed information about renal function tests and drug and alcohol use when he applied for insurance.

House insurance

http://www.ifso.nz/assets/Uploads/130244-2015.pdf
After Denise’s house burned down, her claim for the loss was declined and her policy avoided; Denise hadn’t disclosed her ex-husband’s criminal convictions. They were important because he was living at the house.

Posted by Carey Church



 

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