2. The insured persons or policyholders might sometimes fail to disclose all their personal information to the insurance company. Will such a non-disclosure lead to the rejection of claims? What important facts must be disclosed?
It should be noted that n ot all kinds of personal information are required to be disclosed. The policyholder is only required to disclose personal information that is relevant and important for the insurance company to assess the risks of the proposed insurance coverage. From the insurance company's assessment, a particular risk profile of the proposed insured person is derived. Based on the assessed risk profile, the insurance company sets the terms and conditions and the rate of premium for underwriting the proposed insurance coverage.
An important non-disclosure occurs when the policyholder conceals or fails to disclose known facts that are relevant to the insurance required. For the insurance company to reject a claim, the non-disclosure must be important . That is to say, if the fact or facts are known and factored into the assessment, the resulting risk profile would have been substantially higher, which might have resulted in a higher premium being charged or the rejection of insurance application. Furthermore, the undisclosed facts must be facts that the policyholder could reasonably be expected to know and disclose.
For example, a claim may be rejected if the policyholder did not disclose that the insured person has a heart condition that was serious enough that if this fact had been disclosed, the insurance company would have set a much higher rate of premium or even rejected the application.
If there is uncertainty as to whether or not to disclose a particular piece of information to the insurance company , it is recommended that such information be disclosed to the company in order to avert any future dispute or rejection of claim.