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Non-disclosure

Non-disclosure occurs when a policyholder fails to inform the insurer of material information during the application process or when updating their policy, potentially affecting coverage.

Detailed Explanation

Non-disclosure refers to situations where a policyholder does not inform the insurer of relevant information that could affect the insurer's decision to provide coverage or the terms offered. Under the current duty to take reasonable care (for consumer insurance from October 2021), non-disclosure occurs when a consumer doesn't answer the insurer's questions truthfully and accurately. The consequences depend on whether the failure was innocent, reckless, or fraudulent. For innocent non-disclosure where the consumer took reasonable care but made an honest mistake, the insurer may reduce claim payments proportionately to reflect what premium would have been charged with correct information. For reckless non-disclosure, the insurer can void the policy from inception. Fraudulent non-disclosure allows the insurer to void the policy and potentially refer the matter to police. It's important to note that under current law, the insurer must prove the consumer didn't take reasonable care - they can't simply deny claims because information wasn't volunteered. Insurers must ask clear, specific questions to establish what information they require.

Common Misconceptions

  • Non-disclosure doesn't automatically void your policy - the consequences depend on the type of non-disclosure and when it occurred
  • Forgetting to update your insurer about changes during the policy term is different from non-disclosure at application - you should notify insurers of material changes
  • Insurers cannot use non-disclosure as a reason to deny claims for unrelated matters - the non-disclosed information must be relevant to the claim

Real-World Examples

  • A home insurance applicant didn't mention previous water damage because the insurer's question only asked about fire damage; AFCA found no non-disclosure as the question was too narrow

  • A life insurance applicant failed to disclose they smoked when directly asked; the insurer reduced the death benefit proportionate to the premium difference between smoker and non-smoker rates

  • A consumer didn't disclose a speeding fine from 5 years ago when applying for car insurance; the insurer found this wasn't material to the current risk and paid the claim in full

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