Healthcare Insurance

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Disclosure of material information

Ms. Tsang took out medical insurance in July 2017. Nine months later, Ms. Tsang was hospitalised for 10 days during which a left hemithyroidectomy was performed on a thyroid mass. It was later diagnosed as a benign thyroid nodule. 

Ms. Tsang then filed her medical expenses claim with her insurance company. However, her insurance company rejected her claim as they found that Ms. Tsang was hospitalised because of a transient ischemic attack in February 2017. Because Ms. Tsang failed to disclose this as part of her medical history when taking out the insurance, her insurance company declined her hospitalisation claim on the grounds of material non-disclosure. 

Ms. Tsang then explained that she had been admitted to a public hospital with dizziness in February 2017. Her condition was diagnosed as a transient ischemic attack. Later, Ms. Tsang received a further check up at a private hospital, the results of which proved normal. As a result, Ms. Tsang believed that it was not necessary for her to declare the initial diagnosis at the public hospital. 

In this situation, Ms. Tsang should have disclosed all medical history and information fully and accurately when applying for medical insurance. The necessity to disclose certain medical information does not depend on the result of a medical check-up. If customers are uncertain about what information or medical history is important in applying for medical insurance, it is better for them to declare all information.

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