Hi, everybody, we are on the last episode of Season 11 and I’m focusing on overdisclosure. There is a lot of discussion in our industry about underdisclosure or non-disclosure, but not a lot of focus is put on the times when people tell insurers too much.

It is essential that you answer insurance applications truthfully and to the best of your knowledge, but you don’t need to volunteer information that the insurer doesn’t ask for. It’s one of the reasons why people can be a bit nervous about iGPRs as it does give the insurer a lot more information than they are generally asking for. Insurers are meant to ignore information that is not relevant to the questions that they ask, but that isn’t always the case.

The key takeaways:

• The Consumer Insurance (Disclosure and Representations) Act 2012 means that consumers need to be careful to not misrepresent themselves to insurers, but also explicitly states that consumers do not need to volunteer information to insurers that isn’t asked for
• Insurance for commercial customers works differently as they do not have the protection of CIDRA 2012
• Examples of insurance questions in protection insurance that can lead to both over and underdisclosure

Do you have anything that you want me to cover in Season 12? I will be back soon with deep dives into underwriting and industry insights. 

Remember, if you are listening to this as part of your work, you can claim a CPD certificate on our website, thanks to our sponsors PlannerX.

Kathryn Knowles 00:11

Hi everybody, you just have me today, and we’re going to be talking about over disclosure when it comes to protection insurance in the UK. This is the Practical Protection Podcast, so I’m going to have a little bit of fun today, I think, because I am at home and do my recording, my cockapoo is here and there’s somebody here treating our garden, and I didn’t realize that was going to happen at this timing, and I really don’t have any other time to be recording, so I might need to suddenly pause or do something else while he might as well cockapoo first try to defend my honor against the gardener, but we shall, we shall see. Hopefully, we’ll get through this without too much interruption. So, when it comes to insurance applications in the UK, a lot of focus is put upon under disclosure, because that’s the kind of thing where you are potentially not going to say something to the insurer, which could impact your ability to make a claim on the policy, so that could be anything from the insurer saying, well, we should have known about that, and we didn’t, and actually, if we’d known about it, we’d have charged you a bit more, so we just need to sort out this whole thing in terms of the premiums and the sum assured and make it what it should have been, or they can potentially say sometimes, actually it doesn’t really matter, so don’t worry that you didn’t tell us that it’s fine, we won’t bother about it. The other thing that can happen is that the policy can be what’s known as cancel from inception, so as if it just never even started, so a lot of the time under disclosure can happen for a number of different reasons, so it can be that somebody doesn’t tell the truth in the application form, which isn’t the usual thing that happens, but obviously sometimes it can happen.

The other thing is that it can be that someone’s just not completely understood their medical conditions, or the way that they want to answer certain questions about travel or sports and things like that, it can also be things like that there’s maybe an error in the GP report, so in the medical records, and that can make it seem like there’s a non-disclosure when there actually isn’t, because the reports are wrong, and you might think, How’s that going to happen, but it actually does happen more than you would maybe think, unfortunately, so it is something to be mindful of, but on the flip side of it, that people don’t necessarily talk about too much, is something known as over disclosure, and over disclosure is also an issue, because it can really alter the options that a person can get for their insurances, so I’m just going to go through a little bit around the background of disclosures and insurance, so in UK insurance law, one of the main protections for consumers is, and bear with me while I read this out, it is the Consumer Insurance Disclosure and Representations Act 2012 which is usually shortened to CIDRA, so CIDRA 2012 1012 Now this act changed some of the old rules, so the old rules used to be about you have to answer all the questions in utmost good faith and things like that. So before 2012 insurers were allowed to say that you should have volunteered any material facts, even if they didn’t ask you about it in their question set. Now that is really, really hard, because ultimately people aren’t trained underwriters, you know. How are you to know, or insurance professionals? How would a person, a consumer, be aware of what an underwriter could possibly want to know if it isn’t in the question set, so obviously, and the law agreed to that, so the CIDRA changed things, and basically the key principle is that consumers have to take reasonable care not to make a misrepresentation in answering insurers’ questions, so you must answer the questions as accurately as possible, to the best of your knowledge.

Now, some people can sometimes struggle with that, especially in terms of family medical history, and people can be strained, people can be adopted, and there are questions, there are answers that you can put in those kinds of situations. So, if you are in that situation, please don’t, don’t worry about that. In terms of an insurance application, in the UK, they are much more aware now that not everybody has lots of information in terms of family medical history, but for everything else you need to answer it as best to your knowledge as possible. So basically, answer everything honestly and carefully, but it also means. Means that in general you don’t need to volunteer information that’s not asked for, so insurers need to have made sure that their applications ask what they want to know, and if your disclosure or something in your circumstances doesn’t fit into the insurer’s question set, then you don’t need to tell them. So I will go through some examples of this.

Okay, I will say I’m very, very much advocating that you answer the show’s questions completely and truthfully and wholly to the best of your knowledge, but you also don’t need to give information that they don’t want to know, because as well insurers remember I’m talking about protection insurance, so that’s life insurance, critical illness cover and income protection in the UK. Insurers are obviously asking everything that they want to ask, but they all have different underwriting philosophies. So, different insurers will be interested in different disclosures to each other, and one insurer might see a disclosure and decline it. Another one might class it as standard terms. It is really, really complicated. Okay, but let’s just go back to the main side of things. I’m sure you can possibly hear my dog fudge barking in the background. It’s trying really hard not to be distracted by it. Hopefully, you can’t hear it. So, the law commission notes for the act explicitly say that this removes the consumer’s duty to volunteer information to the insurer, and the ABI summary states, and that’s the Association of British Insurers states the consumer would no longer be required to volunteer information, but only to respond honestly and with reasonable care to the questions asked.

So, if you wanted to look at it a bit more, you do have section 2.2 of CIDRA 2012 and section three of CIDR 2012 that does give more information, but essentially what it says is it is the duty of the customer to take reasonable care not to make a misrepresentation to the insurer, so you just have to be truthful, but that is very, very different to volunteering every conceivable fact that you might or might not know about your health, so what’s really related to this is that if the insurer asks a vague or unclear question that can actually go, in a sense, to the detriment of the insurer, because obviously the regulators say, in terms of consumer duty and consumer fairness, that everything needs to be as clear as possible for consumers to be able to sign up for a contract that they understand and that they have been able to fairly represent themselves, and so the other things that these show is expected to assess clear and specific questions. If something matters to underwriting, it’s not upon the consumer anymore to understand every single thing an insurer might want to know. So, there are some important distinctions. So, CIDRA 2012 applies to consumer insurance, so very, very important there. So, that is, you know, the public, your general person.

The Insurance Act 2015 applies mainly to commercial non-consumer insurance, where there is a broader duty of representation of fair person, fair representation requiring the disclosure of material circumstances. So, basically, when we are looking at these insurances, because there are things like personal insurance, which is the kind of thing that you are arranging yourself, you know, for your own mortgage, or you maybe want some income protection, you want some critical illness cover, things like that, to look after yourself, to pay to yourself if something happens to you that fits within the contract set. Now you then have group, there’s business insurance as well, and then you have group insurance, so group insurance is seen as different group insurance is where you do have a firm and the clients, in a sense, well, the client is the firm, it isn’t an individual, it is the entity, usually a limited company of some sort, and they are seen to need to be making a fair representation of, you know, reasonable facts or material disclosures that they feel the insurer should know. I will talk about a little bit more about that in a bit, and, but it would, it’s complicated sometimes. Okay, so if we are talking about personal motor, home insurance, travel insurance, pet insurance, things like that.

CIDRA 2012 is usually the authority that you want, basically as a consumer, and obviously it does apply to personal protection assurances, like your life insurance, your critical loans cover, and your income protection. So, let’s have a look at some examples, and what I would say is that this episode isn’t going to be a super long one, so it’s a nice short one for you all today. So, when we’re wanting to talk about things that insurers do and don’t want to know, so some insurers ask about motorbike riding, and whether or not you ride a motorbike on the road or not, some don’t and. Now you can find that some of the ones that ask will, you know, potentially really increase the premium if you, if you obviously, if you do ride a motorbike, others where they don’t ask about the motorbike don’t increase the premiums, because they’re not bothered, they’re not asking, it’s not something that’s a concern to them, and that doesn’t necessarily mean that you know there’s there’s lots of going to be issues if you over disclose, necessarily. It could be that the insurer, if you tell them and they, it’s not a question that they just ignore it. They might just try and say, look, we don’t need to know that, so we’re not going to take into consideration. But that doesn’t always work when it comes to way of disclosure. So I’m going to talk about a few examples here at cancer drugs, recreational drugs, specifically, can absolutely influence which insurers you should and shouldn’t be going to, but essentially similar thing with motorbikes, in a sense, so with cannabis, marijuana, and some insurers want to know, some don’t, you know, they will specifically say in a question set, have you taken recreational drugs, with the exception of cannabis, and so you know that they don’t want to know about that, but some of them will say any recreational drug, including, and they will list a load.

Now, what’s important there as well is that when you have something like there’s a list, is that can often be sort of like, you know, have you ever taken recreational drugs, such as, and so they are listing a lot of drugs, but that doesn’t mean that they’ve listed everything, so you do need to be really careful about maybe under disclosing there, but you know, in terms of recreational drugs, a lot of the time insurers will say, now have you used recreational drugs in the last 10 years, so if you’ve used them 12 years ago, you in that in the insurer saying that 10 year time frame, really look out for time frames on the applications all the way through, because the time frames change throughout the application, they usually start off as a “have you ever” then so many last 10 years, then last five years, last two years, last three months, it usually gets shorter and shorter as they go along, so you know, if you took some drugs 12 years ago and the insurer was asking about 10 years, you do not need to tell them about it, but it can influence them if you do, so if you didn’t say anything because it was outside of time frame, then your application would be assessed based upon how the insurer wants to assess it, but you know, we had a situation where that was exactly the situation that the insurer didn’t need to know, but the person that we were supporting was very, very worried about under disclosure, you know, and rightfully so, being worried about it, but obviously their drug use had been outside of that 10 year time from the insurer didn’t need to know, so one of the, they did is that they did like a follow-up communication to the insurer to say, I’ve not done anything in the last 10 years like you’ve asked, but I feel like you should know that 12 years ago, or you know, it was a bit more than that, I was actually taking a significant substance regularly, and I was really quite addicted to it, and, but I’ve not had it for over, you know, over 10 years now. In that situation, it’s different to that motorbike situation I just mentioned, but in that situation, the insurer said we didn’t need to know about it, but now you have told us about it. It is going to be taken into account, and we’re going to be changing the terms that we offered you, which is such a shame. Obviously, completely understand why somebody would want to do that, and want to just like feel like they wants to be doubly, w, w, sure, but ultimately it did mean that they actually had much worse terms because of the fact that they, what’s known as over disclosed. Really, keep an eye out for the question time frames as well, especially around things like mental health and back pain.

The reason I’m mentioning them so specifically is more towards like your income protection side of things, so the back pain isn’t going to cause much of a consideration, really. It does for kind of like little extras with the insurances, but in terms of just some regular back pain for life insurance, it’s probably not going to affect the terms, in terms of like the main core of the life insurance, in terms of the pricing and things like that. Critical illness cover is it’s unlikely again, but income protection, the main key areas for making a claim are mental health and back pain, which is why I’m mentioning so much about the IP there. So, you’ll often get a question in the application that will say, in the last five years, have you had mental health condition, or and there’ll be other things, and then at some point there’ll be a question in the last five years if you have back pain, things like that. Now this can be really tricky to know, because people do visit the GP, and you know, you might forget that you saw a GP four years and nine months ago mentioned your back was a bit sore or something like that, so it can be really. Hard, so it is a good idea to just try and get as much information as you can from possibly your medical records, access your NHS records if you can, see if you had any appointments, what was said, things like that, and double check those time frames, because what we don’t want to do is, if it was like five years, three months ago, well, we can say no, we didn’t have back pain in the last five years, which is good, because then that means we shouldn’t have an exclusion on the policy. Same on the mental health, you know, if you had it and it was six years ago, it wouldn’t need to go in the question in for have you had it in the last five years, but like I was mentioning, we also really need to make sure we don’t under disclose, so if it was four years, 10 months ago, then we are really close to being able to say no to that question, but we need to make sure that we say it, because if not, if a claim were to come in, the insurer would ask for medical records, or at least from the GP, to say, “Can I just confirm, has there been any of these things in the five years before this date? They would say yes, and then the insured say, “Well, we’re not going to pay out a claim for those situations. Very likely would say that, so you know it’s really, really important.

These time frames and checking these questions, because we don’t want anything where they might say, as I say, that it should have been canceled from inception, or potentially say they might not cancel it, but they might say, well, we would have put this exclusion on, so we’re going to, you can still have the policy, but it’s exclusions there, which means you can’t make this claim, which you know is not a situation you want to be in at all. They will often ask us, say, about the last three months. Something else, just very quickly, I’m just jumping over to the under disclosure side again, very, very fast. There is a growing issue in the terms of disclosures in regards to weight loss drugs, such as your ozempic and mounjaro in what’s known as your GLPs, and the reason being is that the insurers’ questions generally will say things like, Have you taken any prescribed drugs for your GP? Have you taken any, you know, drugs that haven’t been prescribed by your GP. Now, what’s important to say is that for the majority of insurers, in the way that their questions are being asked, the weight loss drugs would fall into the question sets based upon the question sets that we’re seeing. I’m just, I’m doing this, recording this in May 2026 It would usually fall in there. Buying from an online pharmacy doesn’t mean you’re getting a prescription, so you can’t say that you are not taking.. hang on, I’m gonna.. I’m gonna get myself really confused now as to say this. So you would need to say that you are taking drugs that are not prescribed by your GP. There we go. Yeah, so you would need to put that information forward, and it is really important, because especially with these weight loss drugs, obviously they’re seeming to have a really, really phenomenal benefit to a lot of people, but there are some things that have also been shown in the background, health factors that aren’t necessarily seen being seen as wholly positive, and insurers are able to offer insurance to people who are taking these drugs, there are some situations where they might not be able to due to other factors as well, and but saying that you’re taking these drugs doesn’t necessarily mean that you’re not going to be able to get the insurance, but there’s a lot of people who are under disclosing, and that is in part the way that the insurance questions are worded and people understanding them, and also just people understanding themselves as to well, if I’m buying it from here or getting it from here, whether or not that is prescription or not.

And another thing, in terms of over disclosure, just because it’s one that, again, we get asked about quite a bit, is HRT, so hormone replacement therapy for women going through menopause, and that is something that usually isn’t disclosed on an insurer’s application set. There’s often a question, and it’ll say in brackets afterwards, you don’t need to tell us about HRT, so that’s just something else. Another key area where we can see over disclosure, potentially, is family history, so insurers tend to ask about immediate family medical history. Now, what we tend to say for that, and I try to make it as clear as possible to people when I ask, and so I do ask it slightly differently to what most insurers’ question sets are. I say it’s your blood-related parents and siblings, that’s it. And so it’s really important that you know it’s just those people, it’s not cousins, it’s not kids, it’s not grandparents or anything like that. The other thing is, is that it’s always asked, well, I say always, bear with me when I say that, so it’s before the age of 65 have they been diagnosed with one of these conditions that would be listed, some insurers ask before the age of 60, so again that can sometimes influence which insurer you go to, and but you know, for some insurers, if they were age 62 you would need to say the majority of insurers, you would say, like, if they’d been diagnosed with breast cancer at age 62 You would need to say, but with some insurers you wouldn’t, because the age cut off for them is 60, so it’s really important to be aware of that. The other thing is, you know, is the condition that your family had listed. If it’s not, then you don’t need to put it forward, but do watch out for inside the these questions that some found in medical history, it does have often includes something about any, it could say like literally, because you’ll be any hereditary condition that you have been advised to have testing for, or some kind of wording along that. So, if there is any kind of hereditary conditions, just really, really double check the wordings again. We don’t want to over disclose if they’ve not asked it.

We don’t need to put it forward, but make sure you’re understanding the actual full context of those sentences, those questions that are there. And just because people might wonder about this as well, some insurers aren’t allowed to ask about genetic testing. That is something that is really important to know, so you don’t need to volunteer and over disclose if you’ve had genetic testing for a condition again, depending upon the background condition, that can have a really, really large effect on the kind of terms that you would get. There is an exception, so that is that insurers are allowed to ask if you have had a genetic test for Huntington’s disease, if you are applying for insurance of over 500,000 pounds of life insurance. It does ask as well for critical illness cover, but the summer show that they ask about is lower for that, so you’d be asked more quickly in terms of that. So, if you are asked about that, then obviously you can, you, you would need to say if you were over the 500,000 for the life insurance, I believe it’s around 300,000 for critical illness cover, but don’t quote me on that one, and you would need to obviously make them aware. Now, what can be really positive, though. What I would say is that if you’ve had genetic testing and, and it has, for some reason, come up in the insurer’s question set somewhere along the way, and then if you’ve had the testing and it’s come back negative, then obviously it can be quite a positive in terms of the insurance process to volunteer the fact that you’ve had a negative test, and that you know there’s there’s been no concerns there, so that can that often comes in a sense that’s kind of like where over disclosure becomes more beneficial, so that can often happen, say again for people with a family history of breast cancer, depending upon how many people have had the breast cancer, the type of breast cancer it was, if there was a genetic link, so that would be something known as a BRCA gene, as a one example.

If you’ve had that test and it was negative, it can be, in a sense, beneficial to over disclose that to the insurer. If you find that when they’ve assessed your application, they’re saying, well, we’d maybe want to increase the premiums or potentially the critical illness cover, they might put a breast cancer exclusion on. So, if you can, then say, right, well, this is what they’re saying. Well, if I, if I over disclose and give this negative result, then actually you might be able to get better terms, which is, is obviously a positive if you can get that. So, just really, really watch out for all those areas, but I think with a lot of those in terms of the over disclosure it can end up obviously I’d say really really changing the outcomes and the quality of the insurance contract that you can get, so as long as you read those questions, you do everything and answer them carefully, you should be absolutely fine, but unless they specifically state something or have one of those open-ended questions, so another open-ended question you can find is to do with spots, which I find really tricky sometimes, because they’ll list all these really, really intense spots, and then they might say, or anything else that could be considered hazardous, and it’s not exactly that wording, but it sometimes feels like it’s like that, and you think, but what you know, what else could possibly be, you know what else do you want to know now? If you ask somebody who is doing something, and you think, hmm, does that fall in that question set, it probably means it does, but that is where, again, speaking with a broker can really, really help, because you know we know what to say yes and no to and what to include in there or not, and we can check with the insurers first and just say with them on a bit of an anonymous basis, right, I’ve got somebody and they have this situation and you know they’re doing xyz, does that fall into this question set and then at least as a record there of the research done and you know, if there’s ever any issues that you’ve had that advice given to you.

So going back to what I was saying before, in terms of disclosure and terms of group cover, so that is, you say, usually for a limited company, it’s usually has to be an entity of some sort, and it’s something where people would need to be on the PAYE. Payroll to be able to have access to it now. CIDRA does not apply there. Okay, so with group insurers are essentially ensuring a group of people is anywhere from two people up from most products now. So, what they do is they group everybody together and say, right, in this group of 20 people, the likelihood of this happening or this happening or this happening is this much, so we’re going to charge everybody this much, and we’re going to accept them all at this level of insurance based upon our data and things like that, so you can potentially insure two people for 500,000 pounds each without any medical underwriting through a group policy, and you know, obviously, that’s that’s really positive, and but there is usually a caveat somewhere, somewhere in the technical documents for these, for insurers who work in this space, and obviously I say that 500,000 pounds, you can just set it up, so in a sense, for each person that is without medical underwriting, that is without going into lots of details.

There’s some details about travel, but not huge amounts, not really any details over sports and things like that. But yeah, you can just set it up super quick, and it’s a really, really positive way of doing what’s known as death in service benefits for a company, but in the technical documents, usually for group, there is a caveat somewhere that basically says that the business must volunteer any information that they think is materially important to the insurer. Now, there was a big to-do about this a while ago, and I think I did an episode on it ages ago, actually, but basically, well, how do you know what the insurer wants to know if they don’t ask now? Because I am a broker who works in the personal business and group space, I pretty much know kind of like what insurers would genuinely want to know about a person if they’re going to insure them, but they don’t on the group side of things, state very specifically. Well, we’d want to know this, this, this, this, and this, because that’s the whole thing with group. It’s meant to just be it’s the business, it’s not the individual who is the client, it is the business who is the client. And it can be really, really tricky to manage, because how is the business meant to know what’s materially important to the insurer?

They’re not insurance experts, and but then also, not all employees don’t have to tell their employer about their health. It’s not something that’s a requirement, you know. There’s obviously very, very specific HR laws that say you do not need an employee protection, so you do not need to tell your insurer about XYZ. So it’s a very, very complicated area. It is. There’s certainly no, there’s no one answer. It is a very, very gray area. What I would say is, I’ve said it did cause a massive debate across the industry. I think it was a couple of years ago, as naturally I was involved in it, as I usually am with the beat about these things, and essentially, what it came down to is everybody has to work in a really, really sensible way, and you know it’s really important, obviously, as a broker, not to do anything that you know absolutely is not going to be okay when it comes to group insurance, so if I give here like a really, really specific example, and it is a very intense example, so I apologize to anybody that this might feel upsetting to, but if somebody approached me in a sense as a broker and has asked me to arrange, you know, some group life insurance for them, their team, you know, obviously, as a broker, I’d go absolutely, and we chat away, and then they say to me, well, the reason is because I’ve actually been told that I have terminal cancer, and I’m going to die in seven months time, and I need this insurance now.

Technically, I could set up that insurance because the insurance question sets and things like that say that you know if they don’t ask about it, but there is then that fair representation, so in the sense of technically I could do it, but I wouldn’t, because I don’t think that that is fair to any party involved, I don’t think it’d be fair on the person, because I really don’t think that the insurance would likely pay out, and that is, it’s not fair to give them that false hope, and their family the potential false hope of that. It’s not fair on the insurer, ultimately, that would be almost certainly guaranteeing that they would make a payout on something that isn’t a product where there’s almost, you know, there are policies that pretty much guarantee to pay out, and this isn’t one of them, and it’s not priced accordingly for that either. And also, it wouldn’t be fair on me as a broker, you know, because ultimately that would mean that I had done something that I personally would feel was very naughty and. And to either the insurer or to the clients, potentially both of them, and morally as well, I wouldn’t want to do that. Some firms might, I would obviously strongly suggest against doing it. And so, what I would say is, if you are a broker working in this space, what’s really, really important is to make sure that you speak with the group insurers yourself, just like we’ve done at Cura, and establish what they mean by materially important to them in material disclosure that would be relevant for them to know.

You’re not going to get a full on list, you might not get the most straightforward answers. I’ll just put that out there, and, but it is important to be very, very aware of what the insurers do and don’t want to know, and what their policies are. So, some insurers do say, ‘Look, our rule is there’s a free medical underwriting limit. We are honoring this free under free medical underwriting limit. We’re not asking anything else. Some ensures say, well, look, we have a free medical underwriting limit, but we want, we would want to know about this, and some say we have the free medical underwriting limit. We do want to know about certain things. So, what we’ve done is, we’ve actually introduced some questions in the question set, just so that we can establish early on if anybody falls into these categories, and then we can obviously potentially offer or not cover if we decide to do that. So, in summary, over disclosure is a bit of a nightmare in all situations, and so is under disclosure, and but on the over disclosure side of things, just be really, really careful, you know, triple check that wording, see what it says. Different insurers ask questions in different ways, so it might be with one insurer you need to answer yes to something, with another you might be able to say no, and that can really alter the outcomes for you if you are someone who’s applying yourself for your client, if you’re a broker, but ultimately the whole thing is just to make sure that you know consumers get that best quality that they can get, and you might need guidance from a broker.

These things aren’t particularly easy, you know, if you do have any disclosures, you know this. I’m somebody who loves to do things myself. I have to say, I really, really do like to go ahead and do things myself, and just dive straight in. So, I fully understand anybody who does that. But if you do have a disclosure, sometimes it can help just to have someone who is doing this day in, day out, to be able to make sure that everything is set up in the right way for you. Well, thank you for listening, everybody. This is the end of season 11, and I’m going to be back soon with season 12. With everything that’s happened in the last year, that if you’re a regular listener, you’ll know about things have gone a little bit out of sync for me in terms of my times with the podcast. So, we’re going to probably have summer season 12 before the summer holidays, some of it afterwards, and just have a little rest during the summer holidays, so we can all have a lovely time in the sunshine. Massively hope I’ve just not jinxed us in terms of the sunshine side of things. So, please visit the website at practical-protection.co.uk to access more episodes, to access your CPD certificates. And a big thank you to Planner X for continuing to do the CPD aspect of the podcast for us. Thank you, everybody. Have a lovely day. Bye bye.

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