CR30 Imputation of knowledge – patent disability

CR30

• Imputation of knowledge – patent disability

Background

Mrs A was the owner of a funeral policy with Company X. When she died, her husband instituted a claim but Company X repudiated it due to alleged non-disclosure of material medical information. Mrs A applied for the policy in 1997 but failed to inform Company X that she was in a motor vehicle accident in 1992 which rendered her a tetraplegic. The policy was sold by an agent of Company X.

Assessment

We were of the opinion that since Mrs A’s condition was clearly visible to the agent of Company X (she was in a wheelchair), the agent’s knowledge should be imputed to the insurer. When we put this to Company X they decided to honour the claim.

Result

The complaint was upheld.

AS

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