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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 0274 Non-Disclosure of Pre-Existing Illness
The assured's claim for hospitalization benefit was declined on the ground that he had failed to disclose in the proposal form that he had high cholesterol level.
The assured applied for two types of policy. He submitted two application forms together with a blood test report. Since the insurers had in their possession the assured's blood test report, they had knowledge of the assured's cholesterol level and the issue of non-disclosure does not arise. However the insurers maintained the blood test report was only furnished to the Life Division of the company but not to the Composite Division.
The assured should not be burdened with the duty to find out how many divisions the insurers have as it is an internal matter of the insurers. As far as the insured is concerned he had submitted the relevant blood test report to the insurers and it is the duty of the officer of the insurers to transmit it to the appropriate division.
In the circumstances the Mediator held that the insurers were not entitled to decline the claim on the ground of non-disclosure of pre-existing illness.
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