Non-disclosure: a common reason life insurance claims are declined

A life policy is a contractual agreement built on honesty and transparency, sometimes referred to as ‘utmost good faith’. This means sharing all relevant information about your health, lifestyle, finances and personal circumstances so that your insurer can assess your risk correctly. If important details are left out, it can lead to claim delays, declined claims or even a voided policy.

“In 2025, Discovery Life paid 99,3% of all claims – a total of R9,1 billion. Of the 0,7% of claims that weren’t paid, 0,4% were because of non-disclosure during the underwriting stage,” explains Gareth Friedlander, Deputy CEO of Discovery Life. “While this is a small proportion, it highlights that non-disclosure remains an important factor when claims are assessed.”

What is non-disclosure?

Non-disclosure is when you leave out important information when taking out or updating your life insurance policy. These are any ‘material facts’ that could affect your premiums or the insurer’s decision to provide cover.

“Non-disclosure can be unintentional as well, so it’s important to understand what needs to be shared from the start,” says Friedlander. “The application process is designed to guide you, but still relies on you providing complete and accurate information.”

Material facts include:

• Previous or current medical conditions and any pending medical exams
• Mental health history, even if the condition is under control
• Lifestyle factors, such as drinking, smoking or vaping
• Your financial information
• Hazardous hobbies or sports
• Details about your occupation
• Other life cover or previous applications for life cover
• Past involvement in illegal activities, criminal charges or convictions

Disclosure isn’t a grilling – it’s about getting your cover right

Disclosing ‘uncomfortable’ facts about yourself doesn’t automatically mean you will be denied cover. It helps insurers understand your risk so they can charge a fair premium for your cover and structure it appropriately. This may include reviewing medical records or requesting additional tests.

Depending on the risk disclosed, the insurer may apply a loading (an additional premium) or an exclusion (a condition or risk that is not covered). These may apply generally or be specific to your circumstances.

When must you disclose?

You must disclose all relevant information when you apply for life cover, before your policy starts. This is known as the “underwriting” phase and allows the insurer to assess the relevance of the disclosure and structure your premiums accordingly.

“If, for example, a policy starts on 1 January 2026, the insurer will assess your risk based on everything up to that date,” says Friedlander. “After that, your cover is in place for future, unforeseen events.”

If you increase your cover or add benefits, you’ll need to disclose any changes to your life, occupation, health or circumstances that can impact your risk level that may have occurred since you last applied for cover. Provided these health or risk changes happened after your cover start date, it will only affect your new cover or benefits, not your existing cover.

What happens if your insurer discovers non-disclosure?

If, when you claim, the insurance company suspects you may not have fully disclosed all risks at inception, it may investigate further. If non-disclosure is proved, depending on the extent of non-disclosure and how much it affected your assessed risk, the insurer may reject your claim and even void your policy, whereby your cover is cancelled.

“In a recent example, a policyholder did not disclose significant alcohol-related health issues and a previous hormonal condition when applying for cover,” says Friedlander. “Medical records obtained after death showed a materially different health profile from that disclosed during underwriting. The policy was voided, no claim was paid, because cover would not have been offered on the true facts.”

In some cases, insurers may retrospectively adjust premiums, exclusions or benefits to reflect what would have applied had the correct information been disclosed. This process, known as policy restructuring, can affect the benefits available at claim stage.

How to avoid your claim not being paid due to non-disclosure

Using a trusted financial adviser can help, but it’s still important to review everything that is submitted. Friedlander suggests the following:

1. When in doubt, disclose

Err on the side of caution. If you’re still not sure that something is relevant, include it. Don’t assume that your medical aid or doctor will provide everything – the only person who knows all your medical and risk information is you. If you disclose something immaterial in the context of your risk assessment, it will not affect the outcome negatively so therefore it is always better to disclose.

2.Take your time

Don’t rush the application. Share complete and accurate information, even if an event occurred many years ago. If anything changes before your cover starts, let your insurer know.

2. Double-check the disclosure documents summary

Carefully check all policy documents both during quote and application stage and after the policy is issued. Review it carefully to make sure everything is correct. If something is missing or inaccurate, raise it with your insurer or adviser.

“Most life insurance claims are paid, but non-disclosure remains one of the most avoidable causes of declined claims. Being open and honest helps ensure your cover works as intended when you really need it,” concludes Friedlander.