Why might my claim be refused?

It’s a good question. Insurance companies say the biggest problems arise when they are faced with a claim, call up the medical records to confirm it, and find that policyholders didn’t give full details of their medical history on their original application forms. This is called ‘non-disclosure’ and can automatically invalidate a policy. Norwich Union says people often fail to mention things like double vision, numbness or giddiness on their application forms. Many people also fail to mention that they were waiting for consultations, tests or test results when they filled in their forms.



Another common problem arises when people don’t fully declare how much they smoke or drink, whether they have any history of depression or whether they have seen the doctor for anything else in the past 12 months. Insurers accept that many people leave off these details for genuine reasons – often assuming that the insurer will get their full medical histories at the application stage and find out about them anyway. But this isn’t how critical illness insurance works. Medical records tend to be called for when you claim, not when you apply for cover. At the application stage the onus is on the policyholder to declare all relevant facts – and if you are unsure about what counts as relevance it is best to err on the side of caution and write it down anyway. ‘You need to take a great deal of care and attention when filling in forms. If you don’t share the information required with insurers then it’s likely that you will have invalidated your policy. And if you make a claim it might be turned down,’ says Norwich Union’s Tony Jupp.

What’s worse is that if a claim is refused by one insurer you will struggle to get similar cover from any other company in the future. So to avoid any potential problems you do need to answer every question properly when you apply for cover.