Travel Insurance - answering health questions

Okell

Can somebody answer a couple of questions for me on the legal position regarding the answering of health insurance questions?

First, I've always understood that provided you answer the questions asked fully, you are covered.  Is that basically correct?

Second, some years ago there was a thread on here where the OP had a claim for medical expenses on holiday turned down by her insurer because she hadn't disclosed a prior consultation with her GP about the possibility of her suffering from depression and requiring treatment.  

Note that the medical expenses she was trying to claim for were related to an accident on holiday, and had nothing whatsoever to do with her depression.

So in that sort of situation is it correct that non-disclosure of something medical that is wholly unrelated to your claim can lead to a claim being refused?

sheramber

when you answer the medical questions the company will review them and decide whether they will cover them and at what cost.

Yes, failure to answer the questions truthfully can result in the policy being void and not paying out a claim.

Do not second guess whether something shoud be declared or not, 
if you are asked for details of anything you have consulted your GP , or other medical person about, then you must declare all cases, not just what you think is relevant.

elsien

Okell said:

Can somebody answer a couple of questions for me on the legal position regarding the answering of health insurance questions?

First, I've always understood that provided you answer the questions asked fully, you are covered.  Is that basically correct?

Second, some years ago there was a thread on here where the OP had a claim for medical expenses on holiday turned down by her insurer because she hadn't disclosed a prior consultation with her GP about the possibility of her suffering from depression and requiring treatment.  

Note that the medical expenses she was trying to claim for were related to an accident on holiday, and had nothing whatsoever to do with her depression.

So in that sort of situation is it correct that non-disclosure of something medical that is wholly unrelated to your claim can lead to a claim being refused?

Yes it can. For a number of reasons - it may be that if you declared the condition then ensure that would either have wanted a higher premium or would have refused cover completely.
Or there could be an indirect link. which is always going to be a matter of judgement but for example someone who is mentally unwell may not be paying full attention to what is happening around, or may be taking more risks,  them hence the accident. 

it can be a bit of a stretch, and there’s always the option of the ombudsman if the insurance company is trying it on but as above it is best to declare everything that they ask for what do you think it is relevant to or not. 

TELLIT01

Our travel policy asks for any appointments with GP or hospital in the past 6 months, either as in-patient or out-patient.  Other than that it will be diagnosed conditions, or any conditions awaiting test or test results.

MyRealNameToo

Okell said:

Can somebody answer a couple of questions for me on the legal position regarding the answering of health insurance questions?

First, I've always understood that provided you answer the questions asked fully, you are covered.  Is that basically correct?

Second, some years ago there was a thread on here where the OP had a claim for medical expenses on holiday turned down by her insurer because she hadn't disclosed a prior consultation with her GP about the possibility of her suffering from depression and requiring treatment.  

Note that the medical expenses she was trying to claim for were related to an accident on holiday, and had nothing whatsoever to do with her depression.

So in that sort of situation is it correct that non-disclosure of something medical that is wholly unrelated to your claim can lead to a claim being refused?

You must answer questions fully, if you do then the insurer will advise what you are and arent covered for. For example an associate had a mental health episode and on disclosure to their travel insurer they excluded any mental health conditions. This continued for 2 years at which point having had no further episodes the insurer removed the exclusion.

CIDRA allows an insurer to void a policy if there are any reckless or intentional non-disclosures irrespective if they are linked to the claim or not. In principle they can decline your claim for your holiday being cancelled due to a firm going bust because you didnt declare your gonorrhoea diagnosis last month though in practice its unlikely to happen as insurers won't ask for medical records if you arent claiming for a medical based claim. 

Its the same with other classes of business, have seen very large claims declined because the insured hadn't declared their partner had been made bankrupt leaving them tens of thousands out of pocket.