Insurance disclosure duty: assess incorrect answers and consequences

1. Find the original question and answer

Request the whole application, not only the insurer’s quotation. Read question, explanation, examples and options together. Which period and person did it concern? Note who completed the form and how you checked answers. Assessment requires exact wording. Keep the final submitted version too. An empty specimen or later questionnaire does not establish what applied then. List ambiguities for your lawyer.

2. Reconstruct knowledge at the time

Create a timeline of facts and available information around application using originals, messages and confirmations. Separate later knowledge from what you knew then. Explain the answer without retrospectively altering records. With health questions, personal descriptions and medical records may differ importantly. Use an appropriate route for sensitive data. Thinking something was not serious does not automatically establish whether the question required disclosure.

3. Distinguish error from intentional deception

Kifid separates intentional deception from other incorrect information. The classification can have serious consequences and should not simply be accepted. Ask for the evidence of intent and identify disputed facts. Saying anyone can make mistakes is not a file-specific explanation: make your account verifiable. Identify an intermediary’s involvement too. Someone else technically completing the form does not automatically remove questions about your checks or information. Assess roles separately.

4. Examine what accurate information would change

The insurer’s hypothetical application assessment may be important. Would it have refused insurance or imposed different terms, premium or exclusions? Request supporting reasoning, not just a conclusion. Kifid explains that health-information consequences without intent depend on such circumstances. Do not assume every error means complete refusal or always payment. Your lawyer can assess the legally appropriate measure and its relation to the actual cause of claimed damage.

5. Also check discovery and notification

Article 7:929(1) BW allows consequences of disclosure breach only if the insurer alerts the policyholder within two months after discovery, mentioning possible consequences. Collect investigation requests, reports received and notification letter. Discovery is not automatically the first isolated suspicion or only the final report date: sufficient knowledge then requires factual and legal assessment. Kifid attached consequences to late notice in a specific AOV case. A late letter on this ground does not automatically solve other coverage or limitation issues; record every date and assess grounds separately.

6. Address each measure separately

The insurer may mention payment, conditions, termination or other effects. Identify what you challenge and the requested change per measure. An application allegation may coexist with current coverage questions. Request reasons and respond with numbered grounds. Keep registration separate too. Adviser error can raise another question about instructions and care, distinct from policy payment. Supply the complete set of decisions at initial consultation.

7. Fictional example: a differently understood question

Suppose an applicant denies prior insurance termination because an old letter seemed an administrative switch. After damage the insurer cites that letter and alleges an incorrect answer. The file needs exact question, termination letter, explanation received and application. A lawyer can assess meaning and appropriate consequences. This fictional example does not say misunderstanding is a sufficient defence. A specific misunderstanding supported by originals differs from a blanket denial of fraud.

8. Checklist for specialist advice

Ask what application facts are missing and whether intent, acceptance policy and deadlines need separate examination. Agree who answers investigation requests and costs. Provide deadlines immediately so obtaining old records does not cause unnoticed expiry.

• Complete application, questions, explanations and submitted answers.
• Original records of information known around application.
• Intermediary or other form completer’s role and communications.
• Investigation, discovery, notification and separate measures.
• Your supported explanation, dates and desired remedy.