Effects of Non-Disclosure of Pre-Existing Medical Conditions

Pre-existing conditions are medical conditions that existed before an insurance policy was
taken out. Insurers usually exclude claims arising from pre-existing conditions, because
insurance policies are intended to cover unexpected occurrences.
Pre-existing conditions could be an injury, illness, sickness, disease, or other physical,
medical, mental or nervous condition, disorder or ailment that with reasonable medical
certainty, existed at the time of application or at any time during the number of years prior
to effective date of insurance.
Problems can arise either because the consumer is unaware of the exclusion or warranty;
or if they are aware, they do not understand what it means in practice or are unsure about
what, if anything, they need to declare. For example:
• Should they tell the insurer about the bad back they suffered six years previously?
• What about the medication their doctor has prescribed for high cholesterol?
• Does it make any difference that their father has had heart problems for many years?
A consequence of not disclosing pre-existing medical conditions or making false or
misleading disclosure is that the applicant (or other claimant) will not be entitled to
compensation or to seek damages for any event that aggravates the pre-existing injury or
medical condition. This will mean that the policy holder would have wasted a lot of money
in paying monthly or annual premiums.
The important thing for any consumer taking out an insurance policy is to declare any preexisting
medical condition he or she may have or suffer from.
NAMFISA Complaints Department: (061) 290 5000 (main) or 290 5133 (Ms Marina K.
Ishidhimba) or 290 5207 (Ms Hilka Alberto), Fax: (061) 290 5122; for online complaints
email complaints@namfisa.com.na; visit www.namfisa.com.na or visit us on the: 6th
Floor, Alexander Forbes House, 154 Independence Avenue, Windhoek.
* NAMFISA treats all information obtained from the public
with confidentiality.
Issued by:
Phillip N. Shiimi