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Insurance Claim - Non Disclosed Incident **UPDATE**

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TheArchitect
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PostPosted: 15:55 - 12 Oct 2016    Post subject: Insurance Claim - Non Disclosed Incident **UPDATE** Reply with quote
Recently had bike stolen. Put claim into insurance. They've now said my claim has been referred to the underwriters as their checks have flagged a claim on me that was prior to me taking out the policy.

Details: I nudged a bus with my car a couple weeks before I took out my bike policy. I stupidly forgot to notify my car insurance immediately and the bus company put in a claim which was being processed. In the midst of all that I bought bike and insured it forgetting to mention the bus incident to bike insurers. Now bike insurance are saying I failed to declare all past claims.
Bus incident went 50/50 which I was happy with and is now resolved.

Question: How fecked am I?
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Last edited by TheArchitect on 15:32 - 22 Nov 2016; edited 1 time in total
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tom_e
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PostPosted: 16:00 - 12 Oct 2016    Post subject: Reply with quote
Pretty fecked.

Worst case they'll void your cover.

Best case they may calculate what your premium would have cost had you declared it and bum you for the extra before handing over any payout.
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TheArchitect
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PostPosted: 16:46 - 12 Oct 2016    Post subject: Reply with quote
fecked in all directions then Sad
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Wonko The Sane
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PostPosted: 16:48 - 12 Oct 2016    Post subject: Reply with quote
so the claim was still open when you purchased the insurance?

Arry, you around mate?
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Ste
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PostPosted: 16:51 - 12 Oct 2016    Post subject: Reply with quote
Bend over.
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Notj7
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PostPosted: 16:52 - 12 Oct 2016    Post subject: Reply with quote
Just a thought - if his cover is voided will he have to then answer "yes" to the question "has your insurance ever been cancelled or declined" (or whatever the similar question is)?

If yes, what about cancelling quick so they don't have the chance.

YOU CAN'T FIRE ME, I QUIT! Middle Finger Middle Finger
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TheArchitect
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PostPosted: 21:41 - 12 Oct 2016    Post subject: Reply with quote
Yep claim was still being processed when I took out bike policy.

I'm prepping for a shafting Crying or Very sad
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arry
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PostPosted: 23:23 - 12 Oct 2016    Post subject: Reply with quote
Wonko The Sane wrote:
so the claim was still open when you purchased the insurance?

Arry, you around mate?


Key part is deliberate act of non disclosure versus innocent non disclosure. What's the exact wording on statement of fact for the bike policy?

Long and short is deliberate non disclosure they'll void. Innocent they'll look for a proportional remedy (what you would have paid had they have known, against what you had paid as a percentage, then applied to total value of claim).

If I've not made that clear - devil in detail, but at all costs you need to sway innocence of non disclosure.
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TheArchitect
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PostPosted: 08:52 - 13 Oct 2016    Post subject: Reply with quote
arry wrote:
but at all costs you need to sway innocence of non disclosure.


gotcha.. cheers Arry!

In all honesty this was a genuine mistake on my part in that the bus incident happened within a week of me buying bike, which was 3 days after my wife gave birth to our son so things were a bit hectic at the time!
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lihp
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PostPosted: 09:00 - 13 Oct 2016    Post subject: Reply with quote
arry wrote:

Long and short is deliberate non disclosure they'll void.


Even if it is unrelated to the claim? After all, nudging a bus with a car doesn't make you more likely to have a bike stolen surely?
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arry
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PostPosted: 09:08 - 13 Oct 2016    Post subject: Reply with quote
lihp wrote:
arry wrote:

Long and short is deliberate non disclosure they'll void.


Even if it is unrelated to the claim? After all, nudging a bus with a car doesn't make you more likely to have a bike stolen surely?


Simply put, yes. If they've asked a clear fair and not misleading question and it's been answered deliberately incorrectly in order to achieve a lower premium or induce the insurer to accept the risk, then that's policy avoidable territory - whatever the circumstances of the claim.

I'm going to go all copy pasta now from a third party site as I've not time to sperge my own version, but in essence CIDRA 2012 reforms is what you need to look up on (latterly, Insurance Act 2015 for Commercial clients).

How will CIDRA bite?

When there is misrepresentation, what will happen? The first step will be to consider whether the insured has breached its duty to take “reasonable care” not to make a misrepresentation. What amounts to “reasonable care” will depend on the relevant circumstances. This seems to be an area which is ripe for debate.

Where there has been a breach of that duty, insurers will have “proportionate” remedies, dependent on whether the misrepresentation was deliberate/reckless or careless.

Quote:
If it was deliberate, the insurer can still avoid the contract. Dishonesty is always classed as deliberate.
If it was “careless” (defined as anything that is not deliberate or reckless), the remedy depends on what the insurer would have done had there been no misrepresentation. For example:
If the insurer would not have entered the insurance contact had it known the true position, then it can still avoid the policy.
If the insurer would have applied different terms to the policy, then those different terms will apply.
If the insurer would have rated the risk differently/increased the premium, then the claim payment can be reduced proportionately.



OP - exact wording of your statement of fact question please.
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TheArchitect
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PostPosted: 09:46 - 13 Oct 2016    Post subject: Reply with quote
arry wrote:

OP - exact wording of your statement of fact question please.


https://i.imgur.com/RlQrbUlh.jpg
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arry
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PostPosted: 10:44 - 13 Oct 2016    Post subject: Reply with quote
The question is loose and non-specific so you're in a bit of luck there.

You'll be making the points that:
It doesn't specify how broad the question could encompass - for example, I could have lost my mobile phone without insurance and by the question wording I'd need to have disclosed it which would have nothing to do with this class of insurance; the question is therefore unreasonable as it should be more specific and because of this it was neither clear nor fair and was misleading.
Because the question wasn't specific enough to narrow the field down, I assumed, entirely reasonably, that it was specific to my motorcycle only as that is the class of insurance I was proposing for; on which I had not had any accidents claims etc, and therefore I believed my answer to be entirely accurate and reasonable in the circumstances; therefore I have not been either deliberately misrepresentative or reckless in my disclosures.

That should get you to a 'careless' misrepresentation position at best for them, and a 'might well get away with it if I complain hard enough and argue my point well enough and the FOS will back me' for you.

Worst case should be proportional remedy and you'd want to push very hard to just pay the additional premium you'd have been due to pay.

Good luck.
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TheArchitect
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PostPosted: 10:48 - 13 Oct 2016    Post subject: Reply with quote
arry wrote:
The question is loose and non-specific so you're in a bit of luck there.

You'll be making the points that:
It doesn't specify how broad the question could encompass - for example, I could have lost my mobile phone without insurance and by the question wording I'd need to have disclosed it which would have nothing to do with this class of insurance; the question is therefore unreasonable as it should be more specific and because of this it was neither clear nor fair and was misleading.
Because the question wasn't specific enough to narrow the field down, I assumed, entirely reasonably, that it was specific to my motorcycle only as that is the class of insurance I was proposing for; on which I had not had any accidents claims etc, and therefore I believed my answer to be entirely accurate and reasonable in the circumstances; therefore I have not been either deliberately misrepresentative or reckless in my disclosures.

That should get you to a 'careless' misrepresentation position at best for them, and a 'might well get away with it if I complain hard enough and argue my point well enough and the FOS will back me' for you.

Worst case should be proportional remedy and you'd want to push very hard to just pay the additional premium you'd have been due to pay.

Good luck.


Many thanks Arry!

Spoke to them yesterday and they said it's with underwriters so have to wait for a response. Do I just sit tight, wait for their findings and then respond with my counter or go in with my case now?
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DrSnoosnoo
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PostPosted: 10:57 - 13 Oct 2016    Post subject: Reply with quote
This is an example of the stupidity in their questioning your claims history. They hold all the details, they do not need to ask the individual.

If they were being thorough before entering their contract, they would check all records them and their industry hold on the individual.

If I want a mortgage, the banks don't say, can you afford this mate? They do their checks of your income etc and decide on what offer to make.

Scvm
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TheArchitect
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PostPosted: 11:08 - 13 Oct 2016    Post subject: Reply with quote
DrSnoosnoo wrote:
This is an example of the stupidity in their questioning your claims history. They hold all the details, they do not need to ask the individual.

If they were being thorough before entering their contract, they would check all records them and their industry hold on the individual.

If I want a mortgage, the banks don't say, can you afford this mate? They do their checks of your income etc and decide on what offer to make.

Scvm


Agreed. I see this as bordering entrapment. They have the means to find the answers to all of these questions yet they choose to ask the questions, almost in the hope that there will be a slip up such as mine.
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Rogerborg
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PostPosted: 11:27 - 13 Oct 2016    Post subject: Reply with quote
When they come back with "You have to declare car incidents on a bike policy," I'd suggest "But you won't accept car NCD on a bike policy. I assumed that you'd have a reasonable, fair and consistent position on that."
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carpe_diem
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PostPosted: 11:58 - 13 Oct 2016    Post subject: Reply with quote
TheArchitect wrote:
DrSnoosnoo wrote:
This is an example of the stupidity in their questioning your claims history. They hold all the details, they do not need to ask the individual.

If they were being thorough before entering their contract, they would check all records them and their industry hold on the individual.

If I want a mortgage, the banks don't say, can you afford this mate? They do their checks of your income etc and decide on what offer to make.

Scvm


Agreed. I see this as bordering entrapment. They have the means to find the answers to all of these questions yet they choose to ask the questions, almost in the hope that there will be a slip up such as mine.


Or in the hope that they'll realise someone (not you, I hasten to add) is trying to pull a fast one. I don't see it as entrapment - it's an honest question to which you're asked to provide an honest answer. I'd have thought that if you'd had an accident three days before being asked the question whether you'd had an accident, if anything you'd be more likely to remember to answer yes (newborn notwithstanding).

DrSnooSnoo, the banks and building societies are now obliged to do an affordability check for a mortgage, which is precisely them asking you if you can afford it, so not sure your analogy holds up there.
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DrSnoosnoo
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PostPosted: 12:07 - 13 Oct 2016    Post subject: Reply with quote
carpe_diem wrote:
DrSnooSnoo, the banks and building societies are now obliged to do an affordability check for a mortgage, which is precisely them asking you if you can afford it, so not sure your analogy holds up there.


While I went through various rough calculations with a mortgage broker to understand our outgoings and what was remaining to pay mortgages etc, yes, the broker conducted no checks to verify I wasn't lying.

Yet when I was to go ahead with the mortgage I had to supply all of my bank and credit card statements to the lender before acceptance.
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Evil Hans
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PostPosted: 12:29 - 13 Oct 2016    Post subject: Reply with quote
Rogerborg wrote:
When they come back with "You have to declare car incidents on a bike policy," I'd suggest "But you won't accept car NCD on a bike policy. I assumed that you'd have a reasonable, fair and consistent position on that."


Excellent point. This is going into my collection of "Best BCF Posts Ever"
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M.C
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PostPosted: 12:51 - 13 Oct 2016    Post subject: Reply with quote
TheArchitect wrote:

https://i.imgur.com/RlQrbUlh.jpg

Interesting how they say whether or not a claim was made. For example a Romanian lorry driver rolled back into my work van, refused to give his details, then denied an accident had taken place (despite seeing his lorry embedded in my van). So without a claim how do you prove an accident took place?
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TheArchitect
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PostPosted: 13:15 - 13 Oct 2016    Post subject: Reply with quote
carpe_diem wrote:
if you'd had an accident three days before being asked the question whether you'd had an accident, if anything you'd be more likely to remember to answer yes (newborn notwithstanding).


You'd think.. except when the incident with the bus happened both myself and the bus driver agreed it was minor enough to just let it be. We both also acknowledged that we would have to notify our respective insurers for sake of being open about it.
I notified my insurer in a 2 minute phone call and left it at that. Because I put so little thought into the whole situation (and the imminent birth of my son playing on my mind) it didn't fully register in my mind as a major incident. So forgotten. It was after I had insured my bike that the bus company put in a claim on me. Even then it was a 2 minute conversation to resolve that it was 50/50 blame...again job done and forgotten.
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tom_e
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PostPosted: 13:21 - 13 Oct 2016    Post subject: Reply with quote
M.C wrote:
TheArchitect wrote:

https://i.imgur.com/RlQrbUlh.jpg

Interesting how they say whether or not a claim was made. For example a Romanian lorry driver rolled back into my work van, refused to give his details, then denied an accident had taken place (despite seeing his lorry embedded in my van). So without a claim how do you prove an accident took place?


They're preying on all the people who think they're doing the right thing by declaring everything and that if they don't the insurance company will magically find out and cancel their policy, easy money for them when they bump up the policy price.
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arry
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PostPosted: 07:14 - 18 Oct 2016    Post subject: Reply with quote
How did you get on OP?
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Motorhate
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PostPosted: 14:46 - 18 Oct 2016    Post subject: Reply with quote
Rogerborg wrote:
"But you won't accept car NCD on a bike policy. I assumed that you'd have a reasonable, fair and consistent position on that."


Can anybody convincingly explain to me why that is the case? I know they're shisters and gangsters but what is their official reasoning for it?

It would be an easy win for any competing bike insurance company would be to simply accept car NCB for bikes.
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