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Our underwriting approach makes the application process easier for you and your clients

Underwriting

Underwriting misrepresentation - Why we can't pay all claims

We’d prefer to be able to pay all claims but if we don't run a responsible policy, then we’re not being fair to our members and other customers.

We’ll only decline a claim for misrepresentation once we’ve looked into it in detail, and only where it’s clear that the misrepresentation affects the claim being made. In many cases misrepresentation can be accidental, but sometimes people can be deliberately dishonest to try to save money on their premium.

We may request medical evidence to validate a claim.

An example

A customer put in a claim for back pain in July 2018 against a policy they took out in September 2017. In the medical evidence we saw they had consulted their GP with back pain in October 2016 and were advised to have physiotherapy. They also had to have their work duties changed so they no longer did any heavy lifting.

The application form completed in September 2017 had the following question:

In the last 5 years, regardless of whether you've seen a doctor, required treatment or had time off work, have you had: Back or neck pain or a condition affecting your back or neck? Including: Sciatica Whiplash Trapped nerves Muscular back pain.

They answered this as ‘No’.

Had we known about the pre-existing back problem we would have excluded this at the time of their application from their policy. However, this customer has still been able to claim for another unrelated condition, just not their recurrent back problem.

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LV=, County Gates, Bournemouth, BH1 2NF, UK