Bank justified in declining claim because application incomplete

Life Insurance,
Simon bought life insurance from his bank and later made a claim after suffering a heart attack. The bank declined the claim, saying he had failed to disclose relevant information about his health when he took out insurance cover. Simon had received earlier advice from his doctor that he had high cholesterol and needed to make lifestyle changes.
August 2019


Our investigation

Simon said it was unfair of the bank to decline his claim because the bank had rushed him to complete the various application forms and had failed to explain clearly what information he was required to disclose. Furthermore, the bank was wrong to say he was on medication when he applied for insurance, and it had also not checked his medical records with his doctor.

The bank’s position was that the the application process was thorough, and Simon had simply failed to provide full and correct information. It was therefore justified in declining his claim.

We considered Simon had not supplied all relevant information when applying for cover, and as a result the bank did not have a clear picture of his health. We found no evidence to suggest the application process was anything but thorough. We also pointed out that Simon had signed documents confirming the information given to the bank was complete.

It is not usual practice for an insurer to obtain medical records at the time an application is made. If an insurer is satisfied with the answers an applicant provides about their health on the application form, the practice is to issue a policy on the basis of the answers given.


We considered the bank’s decision to decline the claim was in accordance with the terms and conditions of Simon’s insurance policy.

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