tmmonline.nz  |   landlords.co.nz        About Good Returns  |  Advertise  |  Contact Us  |  Terms & Conditions  |  RSS Feeds

NZ's Financial Adviser News Centre

GR Logo
Last Article Uploaded: Monday, July 13th, 10:13PM

Insurance

rss
Latest Headlines

Clients complain: Adviser should have told us to obtain notes

A client's complaint that their insurance adviser or insurance company should have told them to request their medical notes when they took out a policy has been dismissed by the Insurance and Financial Services Ombudsman.

Thursday, December 20th 2018, 3:00PM

The couple applied for a range of insurance products, including standalone medical cover, in 2011.

The woman made a claim in 2017.

During the assessment of the claim, the insurer obtained her medical notes.

It retrospectively added an exclusion to her medical cover, on the basis that she had failed to disclose her history of lower back pain.

The couple complained on the basis that the insurer should have requested their notes before the policy began.

Alternatively, they said, their adviser should have told them to get the notes.

The IFSO case manager said the onus was on the client to give the insurer their medical information.

Two other underwriters who were presented with the case said, had they been given the same information, they would have applied an exclusion to the policy.

The case manager said it was material and the insurer was entitled to rely on the non-disclosure clause to alter the terms of the policy

In relation to the adviser's obligation, the IFSO case manager said it was reasonable to expect the adviser to tell a person completing an application about their duty of disclosure, even if there was no statement about it included at the start of the application form.

But the case manager did not believe that there was any active obligation for a financial adviser to specifically advise an applicant for insurance to obtain a copy of medical notes, provided the applicant had been adequately warned about the disclosure obligations.

In this case, there was evidence that the couple had received a warning.

They also complained about a delay in adding their son to their medical policy.

They said they asked the adviser to do so in 2012 but it did not happen until 2013.

When they tried to claim for a tonsillectomy for him in 2015, they were turned down because it was a pre-existing condition.

They said, had the adviser added him when asked, that would not have happened.

IFSO said there was no evidence of that 2012 meeting and so the adviser could not be held responsible.

 

Tags: IFSO insurance

« Not acceptable that ACC doesn't cover illness: OECDIt's time to celebrate insurance and Christmas »

Special Offers

Comments from our readers

No comments yet

Sign In to add your comment

 

print

Printable version  

print

Email to a friend
Insurance Briefs

Less stressed during lockdown
New Zealander’s health and wellbeing had surprising benefits from the Covid-19 lockdown.

Southern Cross supports new safe haven for at-risk pets
Southern Cross Pet Insurance has teamed up with Pet Refuge to provide temporary shelter for animals affected by family violence.

nib Foundation supports Lifeline to the tune of $150,000
To support the growing mental health needs of Kiwis emerging from the Covid-19 pandemic, Lifeline Aotearoa has increased its service capacity thanks to a $150,000 grant from nib foundation, the charitable arm of nib New Zealand (nib).

Southern Cross halves staff numbers
Southern Cross Travel Insurance is slashing its staff numbers from 90 to 45 people.

News Bites
Latest Comments
  • [The Wrap] Dealer group land like a game of Risk
    “Excellent. I've said for a long time that Dealer Groups were a necessary evil. Especially to the new entrant into the...”
    16 hours ago by BayBroker
  • Harking back to the old days
    “Tactical move by CIGNA and looks like they have a lot of bench strength now in sales, underwriting and product / pricing...”
    3 days ago by hitting rock
  • Greens want ACC extended to cover sickness
    “Never happen. The Greens are such an aspirational bunch. Must all the weed. They 'want' all sorts of unlikely things...”
    3 days ago by All hat no cattle
  • Harking back to the old days
    “Really positive news. NZ has been blessed by many successful leaders and it is good that their skills can skill be utilised...”
    4 days ago by Francis L
  • Harking back to the old days
    “I dare say Cigna just got that extra grunt it's been looking for....”
    4 days ago by Matron
Subscribe Now

Cover Notes - Specific news aimed at risk advisers

Previous News

MORE NEWS»

Most Commented On
About Us  |  Advertise  |  Contact Us  |  Terms & Conditions  |  Privacy Policy  |  RSS Feeds  |  Letters  |  Archive  |  Toolbox
 
Site by Web Developer and eyelovedesign.com