Q&As

What are the implications for an insured who participates in clinical trials but fails to notify his insurers of any existing health conditions or potential changes to his health which he discovers as a result?

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Produced in partnership with Julia Dias QC of 7KBW
Published on LexisPSL on 04/01/2018

The following Insurance & Reinsurance Q&A produced in partnership with Julia Dias QC of 7KBW provides comprehensive and up to date legal information covering:

  • What are the implications for an insured who participates in clinical trials but fails to notify his insurers of any existing health conditions or potential changes to his health which he discovers as a result?
  • Obligation to disclose during currency of policy
  • Obligation to disclose on renewal
  • Exclusion for pre-existing conditions
  • Non-disclosure

What are the implications for an insured who participates in clinical trials but fails to notify his insurers of any existing health conditions or potential changes to his health which he discovers as a result?

The following questions potentially arise:

  1. has there been an increase in risk which the insured is obliged to disclose during the currency of the policy?

  2. must the information be disclosed at renewal?

  3. does it attract the operation of an exclusion for pre-existing conditions?

  4. has there been any non-disclosure or misrepresentation?

The insured’s state of health may be relevant to a wide variety of insurance policies, including long-term policies (eg life assurance, income protection or critical illness) and short-term policies (eg private medical, accident, or travel insurance). Some policies may be fully underwritten at the outset by means of a detailed proposal form. Others may only require minimal disclosure at inception but exclude cover for pre-existing medical conditions and/or require notification of changes in the insured’s health.

It is therefore difficult to articulate general rules which are universally applicable and the detailed terms of cover must be checked carefully in every case.

Obligation to disclose during currency of policy

In most long-term contracts, the policy is fully underwritten at the outset and the insurer has the opportunity to conduct a full investigation of the insured’s health for itself. In agreeing to provide cover, it assumes

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