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Case Review: Insurance
Summary of some of the decisions made by the Mediators on some of the complaints received by FMB.
This summary is for information only and should not be used for other purpose.
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FMB/LI 0048 Non-disclosure of Pre-Existing Illness
The insurers declined the assured's claim for total and permanent disability benefit on the ground that he had failed to disclose in the proposal form dated 22.01.2000 that he had diabetes and was treated for heart related problems in 1999.
It was observed that the proposal form requires the assured to disclose whether he has any of the 11 types of illnesses ( major conditions ) listed in the form. Diabetes and heart disease are not included in the list.
When a question in a proposal form is framed in such a manner as to give an insurer all the information which it requires, it may have the effect of limiting an insured's duty of disclosure ( Roberts v Plaisted [1989] 2 Lloyd's Rep 341 ). An insured is entitled to assume that an insurer has framed the questions in the proposal form accurately. He may therefore take the questions at their face value and give his answers accordingly ( Taylor & Anor v Eagle Star Insurance Co. Ltd [1940] 67 LIL rep 136, New India Assurance Co. Ltd v Pang Piang Chong & Anor [1971] 2MLJ 34 ).
Upon being queried the insurers revised their decision and settled the claim.
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