Why 'Fair Go' isn't fair

Why 'Fair Go' isn't fair
Jul 10, 2018

We all know that television and newspaper media can be very one-sided. 

This was certainly the case with a recent story on Fair Go where an individual had a claim declined by an insurer for non-disclosure. Yet again, the insurers are being made to look the bad guys, without all the facts being disclosed in the story. 

You might think that insurers look to avoid paying claims but that is nonsense and completely untrue. If that was the case, I certainly wouldn’t have remained in the insurance industry for the last 30+ years.

We deal with numerous claims, for all types of insurances – health, trauma, life, income protection, etc., and have literally only had a couple of claims declined in the last couple of years. 

The individual that was on Fair Go admitted that he didn’t disclose all his relevant health facts, even though the questions were clearly asked on the application. In one example, he used a prosthesis every night for snoring and sleep apnoea.

When it came to the question asked in his application “sleep disturbances (insomnia or obstructive sleep apnoea)”, no information was provided. There were also other medical questions unanswered. 

When it comes to filling out an insurance application, you cannot simply ask an insurer to get notes from your GP rather than answer any questions fully, as an insurer is only legally allowed to request information based on a specific medical or lifestyle issue and not just full medical notes.

This is due to patient privacy laws set by the Privacy Commission – insurers can’t go fishing for information. 

The best way of avoiding non-disclosure is to find an adviser you trust and carefully complete the application with them. We strongly focus on disclosure so that in the event of a claim, you have certainty that your claim will be met.

It is always sad seeing these stories and hearing about an individual who has had a claim declined. However, there is always a back story leading to the claim decision and intentional non-disclosure is often the cause. 

Remember, non-disclosure can arise on any medical condition not disclosed at the time of application (even if it is not related to the condition you are later claiming for). However, the fact remains that insurance is based on a contract as per all the information disclosed and you are rated accordingly based upon the risk you present. 

When people start to understand this then hopefully we will be able to avoid these sad, one-sided stories on TV. 

To get in touch with Mike and Amanda, please call (06) 751 4510 or email [email protected]tfinancial.co.nz