Critical Illness / non disclosure

andyhill101

Hi Guys

My wife currently has a critical illness claim going through Friends Proident as she has breast cancer. We found out in the past couple of weeks that her aunt (from her fathers side) also had brast cancer about 30 years ago. As we were not aware of this when we took the policy out, does any one know if it will affect the claim ?

Thanks.
Andy

payless

Haven't got FP form to hand- but with most the application only requires parents or siblings info on these matters

HelpWhereIcan

The Friends Provident question on the application form asks:

"Before the age of 60, did either of your natural parents, brothers or sisters suffer or die from .... cancer ... or any other hereditary disorder not listed above?"

Unless the question was different when you applied (I don't recall any insurer ever asking about Aunts, uncles etc but could be wrong) there is unlikely to have been any relevant non-disclosure.

It also matters how old the aunt was at the time of diagnosis.

Even if it could be argued (which I doubt) it is important that you know the current Financial Ombudsman thinking on the matter:

http://www.financial-ombudsman.org.uk/publications/ombudsman-news/27/27-ins-nondisclosure.htm (although there may be a more recent one)

[SIZE=-1][FONT=Verdana, Arial, Helvetica, sans-serif][FONT=Verdana, Arial, Helvetica, sans-serif][SIZE=-1]innocent non-disclosure[/SIZE][/FONT]
[SIZE=-1][FONT=Verdana, Arial, Helvetica, sans-serif]Conversely, if the policyholder’s non-disclosure is innocent, then the firm should meet the claim in full, regardless of whether, if it had known of the matter that was not disclosed, it would have increased the premium or refused to offer cover.[/FONT][/SIZE]

[FONT=Verdana, Arial, Helvetica, sans-serif][SIZE=-1]We are likely to conclude that non-disclosure is innocent if the questions posed by the firm were not clear (or did not clearly apply to the fact(s) in question). We are also likely to conclude this if we consider it was reasonable for the policyholder to have overlooked the fact(s) that he or she failed to disclose. This could be the case, for example, with minor childhood ailments or minor motoring offences that occurred more than four years earlier. [/SIZE][/FONT]
[/FONT][/SIZE]

There is also inadvertent non disclosure

In such cases, the matters that the policyholder failed to disclose are likely to be minor, distant in time or otherwise easy to have been overlooked.

...

[FONT=Verdana, Arial, Helvetica, sans-serif][SIZE=-1]If we conclude that the policyholder’s non-disclosure was inadvertent, then we will look at whether a decision by the firm to cancel the policy, decline the claim and return the premiums would produce an outcome that is manifestly unfair. [/SIZE][/FONT]


[FONT=Verdana, Arial, Helvetica, sans-serif][SIZE=-1]The outcome is likely to be unfair if:[/SIZE][/FONT]

[FONT=Verdana, Arial, Helvetica, sans-serif][SIZE=-1]the firm would have offered cover (albeit on somewhat different terms) if it had known of the matter that the policyholder failed to disclose; and [/SIZE][/FONT]
[FONT=Verdana, Arial, Helvetica, sans-serif][SIZE=-1]the loss/claim is not associated with that matter.[/SIZE][/FONT]

A family history of breast cancer in just one relative (especially when the relative that far removed) is not likely to lead to an outright decline in cover in my experience.

Also the ABI Code of Practice says pretty much the same

http://www.out-law.com/page-8968

I really don't think it should be an issue, not least because Aunts, Uncles etc normally do not come into it.

Speak with your adviser to see what help they can offer.

You and your wife have enough to worry about at the moment.

All the best.

skint_chick

The FP application form only asks about parents and siblings in the family history section so an aunt shouldn't affect the claim. There are no questions about other relative's medical histories so as long as your wife didn't forget to disclose any information about her direct family then you should be ok about the aunt

HTH

koexelek

HelpWhereIcan wrote: »

The Friends Provident question on the application form asks:

"Before the age of 60, did either of your natural parents, brothers or sisters suffer or die from .... cancer ... or any other hereditary disorder not listed above?"

Unless the question was different when you applied (I don't recall any insurer ever asking about Aunts, uncles etc but could be wrong) there is unlikely to have been any relevant non-disclosure.

agreed.
If I had been the adviser, and you had told me about the aunt, I would not even have mentioned it.
You have to answer all questions honestly and truthfully, but don't have to go into the history of more distant relatives if you are not asked to

Dan_1976

Aunt is to far removed I would say as you have all said. I would not have removed it.

I remember going through this with a nurse client, and she was saying its crazy as there is not evidence to say cancer is hereditary.

Andyhill I hope this goes smoothly, we are here to help, more so the current FA's. I wish your wife good health. Dan

andyhill101

Guys.
Thank you so much for the advice. We are going through hell at the moment and that is one less thing to worry about.
God bless you all.

Andy & Emma.