AN INSURANCE COMPANY refused to pay a woman’s claim after an accident because she told them in her claim form that she was unemployed.
The woman had listed her occupation as ‘gardener’ when she renewed her policy, but was unemployed at the time of the claim. Her case is one of a number of examples given in an annual report by the Financial Services Ombudsman this week.
The ombudsman’s office said that in 2017 there were 1,914 complaints about insurance.
In this instance, the woman was asked her occupation when she renewed her policy and she told the company she was a gardener.
Following an accident, she submitted a claim in which she stated that she was unemployed. The provider declined the claim on the grounds that she had not disclosed that she was unemployed at the time of renewal.
The woman claimed that the information she provided upon renewal was accurate, as she had been working as a gardener in the community on a voluntary basis, and that she had provided the information in the interests of full disclosure.
During mediation facilitated by the Ombudsman’s office, the provider agreed to assess her claim and subsequently paid her over €4,000.
Complaints about insurance products and services accounted for 42% of all complaints received in 2017. Similar to 2016, motor insurance was the main product type complained about, representing 33% of insurance complaints.
Another example given in the report was of a woman whose car insurance was cancelled due to non-disclosure when she was applying for the policy.
The non-disclosure related to whether or not she had been involved in an accident – regardless of blame – in the past three years. As a result of the cancellation, she struggled to afford insurance premiums, and it negatively affected her business.
As part of a mediated agreement, the provider decided to rescind the cancellation on the basis that the woman may not have fully understood the questions because English was not her first language.
She also received a refund of the premium loading applied during the period in question. Although this was not a large sum, the woman felt this was a significant result as it provided financial freedom and the ability to shop around for new cover.
Speaking to TheJournal.ie last year, ombudsman Ger Deering expressed concern about insurance companies refusing claims and cancelling customers’ policies because of minor non-disclosures.
In many of these cases, companies are asking “vague questions” and leaving it to the consumer to decide whether something is a material issue.
“I would say that consumers need to be very careful about the kind of questions they’re being asked and answer them correctly and providers need to ask the questions in a clear manner that is understandable,” he said.
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