Tell The Insurers Everything When You Apply For Life And Critical Illness Insurance.

The failure to disclose information, especially medical information, is the most common reason why an insurer will reject a claim on a life or critical illness policy. To help underline some issues, we want to tell you a true story - but we've concealed the policyholders' name and a few other aspects to preserve anonymity.

Mrs A was fighting a secondary infection following surgery to remove cancerous lymph nodes in her groin when she received further bad news. Her critical illness insurer was refusing to pay out the ฃ200,000 she was expecting. To understand why and the issues involved it's useful to understand how the events unfolded.

• In June 2001, Mrs A visited her GP after discovering a patch of flaky skin on her back. Mrs A thought it was eczema. During a brief consultation, her GP thought that it should be looked and recommended a referral to a dermatologist. But soon afterwards the flaky skin healed and Mrs A cancelled the appointment with the dermatologist. Apparently her GP did not express any major concern and some years later admitted that Mrs AP was in all likelihood unaware of the urgency of the referral.

• Nine weeks later a sales representative from Standard Life made a routine visit to Mrs A at her home. As Mrs A was now alone with a young family, the representative reviewed Mrs A's life insurance cover and suggested that she should also have a ฃ200,000 Critical Illness policy. Mrs A thought that sounded a very good idea and willingly agreed there and then.

The sales representative produced the form and went through it, question by question, writing down Mrs A's answers for her. When it came to the question asking Mrs A to disclose all occasions her GP had recommended referrals for tests or treatments, Mrs A asked the sales representative what Standard was asking for. Mrs A alleges that the representative replied that Standard only needed details of appointments that related to serious conditions. Mrs A did not believe that her referral for what she thought had been eczema, fell into that category - so she did not mention it. She then signed the form honestly believing that she had disclosed everything Standard Life had required.

Standard subsequently accepted her application and issued the ฃ200,000 Critical Illness Insurance policy.

• Two years later Mrs A was found to have skin cancer. Major surgery rapidly followed to remove the cancer. As her critical illness policy included cover for her cancer, Mrs A then made what she thought was a valid claim.

• Standard Life subsequently rejected her claim on the basis of “reckless non-disclosure” – the insurers' jargon for Mrs A's failure to disclose her cancelled appointment with the dermatologist.

The Issues

The events that followed showed that Mrs A's application should have included her referral to the dermatologist. So why didn't she disclose the information?

It seems that two aspects conspired to create the situation: Standard Life's sales representative told Mrs A that the question on the application form asking for “all occasions her GP had referred her for tests or treatments” as only relating to serious conditions. That interpretation was fundamentally wrong. The question asked for ALL OCCASIONS. These questions are worded carefully and ALL means ALL - it is not asking the applicant to make a personal judgement as to whether the grounds for the referral were serious or not. The representative was clearly wrong.

Secondly, the GP did not apparently convey to Mrs A the potential seriousness of her flaky skin and her referral to the dermatologist. If, when the insurance application was being completed, Mrs A was unaware that her condition was potentially serious and the representative said the referral question only related to serious conditions, Mrs A can hardly be held responsible for not disclosing that information.

In our view, and on the basis of the information provided to us, Mrs A is not to blame. Standard Life's representative made the vital error. He gave incorrect guidance on what the question at the heart of the dispute, was asking for. In our view Standard Life should pay out.

The lessons to be learnt

Always very carefully read each question on an insurance application form - and answer the question FULLY and ACCURATELY. Do not be tempted to be economical with the truth. If you do omit something they ask for, the insurance company can rightfully claim that you mislead them by omission. Never be tempted to omit some information in order to qualify for a cheaper premium. You might get a cheaper premium, but that's a false economy if a subsequent claim is rejected.

We hope Mrs A will get her payout as she was mislead by circumstances beyond her control. We believe she acted honestly. She deserves her payout and our best wishes.

However, those applicants who deliberately withhold information from their insurer or who provide misleading information, do not.

Postscript : Reports show that Standard Life refuse 5% of all Critical Illness claims due to non-disclosure. Some other insurers have much higher figures - Legal & General reject 16% and Friends Provident reject 15%. The insurance industry is trying to improve this situation by the ways they seek information from applicants and by the way the penalties for no-disclosure are explained.

The Two Basic Kinds Of Life Insurance

Life insurance offers every consumer a way to take care of loved ones for years to come, even if he or she won’t be around to put food on the table. The basic idea of life insurance is that during an insured person’s lifetime, he or she makes monthly payments to an insurance company. When the insured person passes away, the beneficiaries of his or her policy, usually immediate family members, make a claim and the insurance company writes them a check for the value of the policy. In many cases, the amount the beneficiaries receive is higher than the amount of money the customer put into the policy.

There are two basic kinds of life insurance. The first, called term life insurance, is bought for a discrete period of time at a fixed premium. It includes nothing above or beyond a basic death benefit. This is an increasingly popular form of life insurance. The second kind of policy, known as a whole life insurance policy, is a bit more complicated. A customer contributes to his or her whole life insurance policy on a monthly basis for the duration of his or her life. The premiums fluctuate over time, and tend to follow a gentle upward curve as the customer ages. In addition to including a basic death benefit, whole life insurance includes an investment component that is meant to help the customer grow his or her wealth. This makes whole life insurance substantially more expensive than term life insurance, but many people argue the increased fees are worth it because you get more for your money.

How much life insurance you need has quite a bit to do with how much you can afford to spend on a life insurance premium each month; but it has equally as much to do with how much coverage your family’s lifestyle and situation requires you to have. It is a good idea to try to provide your beneficiaries with a policy that will offer them enough to cover your funeral expenses and to continue to meet their living expenses for as long as possible without facing financial hardships. There are multiple worksheets available online that can help you make an educated estimate as to how much coverage you should aim for, but it is crucial that you discuss your situation with an experienced and trustworthy professional before you make any firm decisions about what kind of life insurance policy to purchase.

Life Insurers Use The Body Mass Index To Tighten The Belt On Fat People

Overweight people are in the firing line again. Life insurance companies are increasing premiums up to four fold for fat people. They've always charged more for those of us who over-eat, but during the last year the penalties have got worse.

In moves to tighten the belts further, the life insurers are lowering the weight limits they use to categorise people. This tougher move means that those who are merely overweight and would have previously qualified for a standard premium, are now penalised with higher premiums – and the premium rapidly rises the more overweight they believe you are.

Height and weight are just two of the questions you have to answer when you apply for life insurance. From them, the life company calculates your Body Mass Index and if that exceeds the limits they define as acceptable, they might ask for a doctor's report. In bigger cases they might ask you to have a medical examination. If this confirms that your weight is of concern, then you can expect your premium to be loaded by at least 50% and as much as 400% if you're really obese. Recent research shows that around 25% of applicants will experience problems getting life cover due to their weight. In extreme cases the insurer will even refuse the application.

In an acknowledgement of normal middle age spread, the insurance companies do take your age into account when deciding your premium. They accept that people naturally tend to put weight on as they age. If you're young and overweight, however, they'll certainly hit you hard. So overweight and 38 will be hit much harder than overweight and 58.

For example, a non smoking healthy man aged 35 asking for ฃ150,000 level cover over 25 years will currently be quoted ฃ18.77 by Scottish Provident but this could easily jump to ฃ35 if he is overweight and up to ฃ47 if he's obese.

And obesity is certainly a growing problem. Over the last 20 years obesity in adults has rocketed with more than 60% of men and 50% of women being judged as overweight or obese. And signs are that the problem won't improve. In children aged between 2 and 15, 28% of girls and 22% of boys are overweight.

How do you rate on the Body Mass Index?

Calculate your own BMI.

Note your weight in pounds and multiply it by 703.


Divide the result by your height measured in inches


Again divide the resulting number by your height in inches


The result is your BMI


The typical insurance company considers a BMI of between 18.5 and 24.9 to as normal. Above 25 classifies you as overweight. Over 30 and you're obese.

To give you more of a fix on what this means for you, here are the BMI's for twelve famous people:

Under weight

Paula Radcliffe – Marathon Runner - 18.0

Victoria Beckham – Footballers Wife - 17.0

Jennifer Aniston – Actress - 17.5

Normal weight

Alan Shearer – Newcastle Footballer - 24.4

Davina McCall – TV Presenter - 20.8

Cilla Black – Presenter - 20.7

Overweight

Russell Crowe – Hollywood Actor - 25.6

Ann Widdecombe – MP - 25.1

Charlie Dimmock – Gardening Presenter - 26.0

Obese

Norman Schwarzkopf – US General - 30.5

Michelle McManus – Presenter - 34.4

Dawn French – Comedienne - 43.8