Life Insurance Company request medical records

CD2

Hello,

Question for somebody working in life assurance!

My mam and dad have a life insurance policy the last 20 years. Both listed as non smokers. They were at the time they took the policy out but dad is an occasional smoker now.

I'd like to know if dad died and the death cert listed the cause of death as an illness that could be related to smoking e.g. heart disease, lung cancer, could the insurance company request medical records before paying out. And if so how does this work under GDPR and FOI. Do they request the records from the claimant (his spouse / my mam) and then mam would have to request them from GP or hosp.

Reason I'm asking is they're in their late 60s now. The premium is going to keep increasing every 5 years as they get older. I'm wondering should they just give up the policy now, especially if theres a risk of them not getting a pay out.

Any advice appreciated.

The J Stands for Jay

CD2 wrote: »

Hello,

Question for somebody working in life assurance!

My mam and dad have a life insurance policy the last 20 years. Both listed as non smokers. They were at the time they took the policy out but dad is an occasional smoker now.

I'd like to know if dad died and the death cert listed the cause of death as an illness that could be related to smoking e.g. heart disease, lung cancer, could the insurance company request medical records before paying out. And if so how does this work under GDPR and FOI. Do they request the records from the claimant (his spouse / my mam) and then mam would have to request them from GP or hosp.

Reason I'm asking is they're in their late 60s now. The premium is going to keep increasing every 5 years as they get older. I'm wondering should they just give up the policy now, especially if theres a risk of them not getting a pay out.

Any advice appreciated.

I believe they'll be fine as there weren't smokers at the time of completing the application form.

skippy2

Do they need Life Insurance at this stage in their lives especially as it gets more expensive.
Can the other partner survive on existing pension, income etc should one die
Is the mortgage if there is one paid off
I presume all their children are self sufficient so do not need supporting.

Jim2007

McGaggs wrote: »

I believe they'll be fine as there weren't smokers at the time of completing the application form.

You obligation to disclose relevant events does not end with completion of an instance application form.

antix80

Ideally they should write a letter stating the year he started smoking. Keep the response with the policy document.

The J Stands for Jay

Jim2007 wrote: »

You obligation to disclose relevant events does not end with completion of an instance application form.

It's been a while. I must be thinking of insurable interest.

Jim2007

CD2 wrote: »

I'd like to know if dad died and the death cert listed the cause of death as an illness that could be related to smoking e.g. heart disease, lung cancer, could the insurance company request medical records before paying out.

No assurance company is going to pay out a significant amount of money without fully checking out the circumstances.

And for someone making a claim on a non-smoker's policy to die of a smoking related cause, is going to be a big red flag for the loss adjusters. For all they know the person could have always been a smoker... failed to inform the company of a very significant change to their circumstances and the nature of the insured risk.

Henry Ford III

Jim2007 wrote: »

You obligation to disclose relevant events does not end with completion of an instance application form.

I think in this instance it does.

A smoker may apply for a premium reduction if they haven't smoked for 12 months, but an insurer can't increase a premium for somebody underwritten as a non smoker and who takes up smoking subsequently.

GerardKeating

Jim2007 wrote: »

You obligation to disclose relevant events does not end with completion of an instance application form.

It does for Life Assurance, but not for General Insurance where one has an ongoing duty to disclose changes in risk etc.

Henry Ford III

GerardKeating wrote: »

It does for Life Assurance, but not for General Insurance where one has an ongoing duty to disclose changes in risk etc.

Every renewal involves a fresh declaration and potentially new underwriting.

I recall a case I was involved in a few years ago. A life assurance claim. Insured was drowned - sub aqua diving. Wasn't disclosed at proposal stage, but it was determined he only took up diving subsequently. Claim was paid.