When an insurance claim for a life policy is rejected, it is often mistakenly assumed that this decision was made by the insurer. However, the most common and preventable reason for non-payment of claims is that the applicant failed to provide all necessary information when submitting the application.
This factor is called non-disclosure. Although it accounts for a small portion of rejections, it is almost entirely preventable. In 2025, Discovery Life paid out 99.3% of all claims totaling R9.1 billion. Of the small fraction that was not paid, 0.4% were rejected specifically due to non-disclosure during the underwriting stage—that is, at the time of the initial request for coverage.
Gareth Friedlander, Deputy CEO of Discovery Life, notes: 'Although it is a small fraction, it underscores that non-disclosure remains an important factor in assessing claims.'
What Constitutes 'Non-Disclosure'?
Non-disclosure is simply withholding a material fact when applying for or renewing a policy. A material fact is information that could reasonably affect either the premium amount or whether you would be offered coverage at all. It does not necessarily have to be intentional; many instances occur accidentally because people do not realize the significance of a particular detail.
Insurers are typically interested in receiving information about the following:
- Any past or current medical conditions, including expected tests or examinations
- Mental health history, even if currently well-managed
- Lifestyle, such as smoking, vaping, or alcohol consumption
- Your financial situation
- Risky hobbies or sports
- Your profession
- Any other insurance coverage you hold or have applied for
- Past criminal charges or convictions
Insurers request this information not to automatically deny you. Providing even inconvenient information helps the insurer accurately calculate your risk. Based on the data received, they may request medical records or additional tests, increase the premium (apply a surcharge), or establish an exclusion for a specific illness. Coverage itself is rarely denied completely.
When Is Information Disclosure Necessary?
The critical period for disclosure is before the policy takes effect, known as the underwriting phase. All relevant information pertaining to that date must be provided. After this, you are insured against any subsequent events. If you later increase coverage or add an additional benefit, you will need to report any relevant changes that have occurred since the last application, but this only affects the new part of the coverage, not the existing one.
What happens if non-disclosure is discovered during the claims process?
If the insurer suspects that some information was hidden, they may conduct an investigation, sometimes only after a claim has been filed. Friedlander cites an example where the policyholder did not disclose a serious health issue related to alcohol, nor a previous hormonal condition. Medical documents obtained after death showed a completely different picture compared to what was stated upon application. Since coverage could not be offered based on the true facts, the policy was cancelled, and the claim was not satisfied.
In less severe cases, insurers may retrospectively adjust premiums, exclusions, or benefits to reflect what should have applied, which can still affect the payout amount.
Three Practical Habits That Protect Your Claim
To protect your claim, it is recommended to follow three rules: when in doubt, disclose the information. Even providing irrelevant information will not harm you, whereas concealing a material fact can have negative consequences. Do not rush to apply. Provide complete and accurate answers, even to questions about events that happened many years ago, and note any changes before the actual start of your coverage. It is also important to carefully review policy documents both when obtaining an assessment and after issuance, and challenge any suspicious points with your insurer or advisor.
As Friedlander states, most claims are settled, and non-disclosure is one of the few factors that is entirely within your control to avoid. If you are unsure what information to disclose for your own policy, an accredited financial consultant from Discovery can help you sort out this issue, as well as familiarize you with the structure of Discovery Life coverage before applying or making changes.