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The duty to take reasonable care not to make a misrepresentation

Hostplus has a contract of insurance with MetLife Insurance Limited ABN 75 004 274 882 AFSL 238096 (‘MetLife’ or the ‘Insurer’) to provide the insurance benefits for members of the Fund. On becoming a member, you are bound by the terms and conditions of this contract of insurance.

When you apply for life insurance, the insurer will ask you a number of questions.

MetLife’s questions will be clear and specific. They will be about things such as your health and medical history, occupation, income, lifestyle, pastimes, and other insurance.

The answers given in response to their questions are very important. They use them to decide if they can provide cover to you and, if they can, the terms of the cover and the premium they will charge.
!   Care must be taken to answer all questions the insurer asks as part of your insurance application honestly and accurately.


Otherwise, you may not be able to rely on your insurance when it’s needed the most.

The duty to take reasonable care

When applying for insurance, there is a duty to take reasonable care not to make a misrepresentation.  

A misrepresentation could be made if an answer is given that is false, only partially true, or that does not fairly reflect the truth.  This means when answering the Insurer’s questions, you should respond fully, honestly and accurately.

The duty to take reasonable care not to make a misrepresentation applies any time you answer the Insurer’s questions as part of an initial application for insurance, an application to extend or make changes to existing insurance, or an application to reinstate insurance. 

You are responsible for all answers given, even if someone assists you with your application. 

MetLife may later investigate the answers given in your application, including at the time of a claim.

Consequences of not complying with the duty

If there is a failure to comply with the duty to take reasonable care not to make a misrepresentation, it can have serious consequences for your insurance, such as those explained below: 

Potential consequences Additional explanation Impact on claims
• Your cover being avoided This means your cover will be treated as if it never existed Any claim that has been made will not be payable
• The amount of your cover being changed Your cover level could be reduced If a claim has been made, a lower benefit may be payable
• The terms of your cover being changed We could, for example, add an exclusion to your cover meaning claims for certain events will not be payable If a claim has been made for an event that is now excluded, it will not be payable

If the Insurer believes there has been a breach of the duty to take reasonable care not to make a misrepresentation, they will let you know the Insurer’s reasons and the information they relied on and give you an opportunity to provide an explanation.

In determining if there has been a breach of the duty, the Insurer will consider all relevant circumstances. 

The rights the Insurer have if there has been a failure to comply with the duty will depend on factors such as what they would have done had a misrepresentation not been made during your application process and whether or not the misrepresentation was fraudulently made.   

If the Insurer decides to take action on your cover, they will advise you of their decision and the process to have this reviewed or make a complaint if you disagree with their decision.

Guidance for answering the Insurer's questions

When answering MetLife’s questions, please:

  • Think carefully about each question before you answer. If you are unsure of the meaning of any question, please ask MetLife before you respond. 
  • Answer every question that MetLife ask you.  
  • Do not assume that MetLife will contact your doctor for any medical information. 
  • Answer truthfully, accurately and completely. If you are unsure about whether you should include information, please include it or check with us.
  • Review your application carefully. If someone else helped prepare your application (for example, your adviser), please check every answer (and make corrections if needed) before the application is submitted. 

Other important information

Your application for cover will be treated as if you are applying for an individual ‘consumer insurance contract’. For this reason, the duty to take reasonable care not to make a misrepresentation applies. 

Before your cover starts, the Insurer may ask about any changes that mean you would now answer their questions differently. As any changes might require further assessment or investigation, it could save time if you let the Insurer know about any changes when they happen.

If after the cover starts, you think you may not have met your duty, please contact us immediately and we’ll let you know whether it has any impact on your cover.

It’s important that you understand this information and the questions we ask, so if you have any queries please contact us on 1300 467 875

 

When you apply for life insurance, the insurer will ask you a number of questions.   

MetLife’s questions will be clear and specific.  They will be about things such as your health and medical history, occupation, income, lifestyle, pastimes, and other insurance. 

The answers given in response to their questions are very important. They use them to decide if they can provide cover to you and, if they can, the terms of the cover and the premium they will charge.

The duty to take reasonable care

When applying for insurance, there is a duty to take reasonable care not to make a misrepresentation.  

A misrepresentation could be made if an answer is given that is false, only partially true, or that does not fairly reflect the truth.  This means when answering the Insurer’s questions, you should respond fully, honestly and accurately.

The duty to take reasonable care not to make a misrepresentation applies any time you answer the Insurer’s questions as part of an initial application for insurance, an application to extend or make changes to existing insurance, or an application to reinstate insurance. 

You are responsible for all answers given, even if someone assists you with your application. 

MetLife may later investigate the answers given in your application, including at the time of a claim.

Consequences of not complying with the duty

If there is a failure to comply with the duty to take reasonable care not to make a misrepresentation, it can have serious consequences for your insurance, such as those explained below: 

Potential consequences Additional explanation Impact on claims
• Your cover being avoided This means your cover will be treated as if it never existed Any claim that has been made will not be payable
• The amount of your cover being changed Your cover level could be reduced If a claim has been made, a lower benefit may be payable
• The terms of your cover being changed We could, for example, add an exclusion to your cover meaning claims for certain events will not be payable If a claim has been made for an event that is now excluded, it will not be payable

If the Insurer believes there has been a breach of the duty to take reasonable care not to make a misrepresentation, they will let you know the Insurer’s reasons and the information they relied on and give you an opportunity to provide an explanation.

In determining if there has been a breach of the duty, the Insurer will consider all relevant circumstances. 

The rights the Insurer have if there has been a failure to comply with the duty will depend on factors such as what they would have done had a misrepresentation not been made during your application process and whether or not the misrepresentation was fraudulently made.   

If the Insurer decides to take action on your cover, they will advise you of their decision and the process to have this reviewed or make a complaint if you disagree with their decision.

Guidance for answering the Insurer's questions

When answering MetLife’s questions, please:

  • Think carefully about each question before you answer. If you are unsure of the meaning of any question, please ask MetLife before you respond. 
  • Answer every question that MetLife ask you.  
  • Do not assume that MetLife will contact your doctor for any medical information. 
  • Answer truthfully, accurately and completely. If you are unsure about whether you should include information, please include it or check with us.
  • Review your application carefully. If someone else helped prepare your application (for example, your adviser), please check every answer (and make corrections if needed) before the application is submitted. 

Other important information

Your application for cover will be treated as if you are applying for an individual ‘consumer insurance contract’. For this reason, the duty to take reasonable care not to make a misrepresentation applies. 

Before your cover starts, the Insurer may ask about any changes that mean you would now answer their questions differently. As any changes might require further assessment or investigation, it could save time if you let the Insurer know about any changes when they happen.

If after the cover starts, you think you may not have met your duty, please contact us immediately and we’ll let you know whether it has any impact on your cover.

It’s important that you understand this information and the questions we ask, so if you have any queries please contact us on 1300 467 875