Copy below is taken from a Financial Adviser Guide relevant to persons DECLINED, POSTPONED or offered cover on SPECIAL TERMS
Special terms are that:
• your customers either has to pay an extra premium charge;
• accept an exclusion; or
• we may have deferred cover at this time.
What does this mean?
This means that we feel we need to charge an extra premium
or exclude part of the cover because of past health or we
cannot offer the cover applied for. A customers past health,
in this context, could also include family medical history.
How did you reach this decision?
We came to this decision only after very carefully considering
the details in the application for cover and perhaps details
from your customers GP or following a medical examination
done on our behalf. We have access to and use large banks
of statistical information in arriving at these decisions. Most
decisions are based on known medical histories such as
asthma, raised blood pressure and so on, rather than new
previously unrecognised findings. Please remember that we
made the decision, and not any doctor who examined the
Suggested next steps
Tell the customer we have made a decision.
It is generally better to do this in person rather than by phoning.
Do not avoid letting the customers know about our decision. In
a lot of cases the customer may be expecting us to make this
decision if they have a known health history. This is particularly
true if you told them about the possibility of adverse terms at
the time they filled in the application form. (Talking to an
Irish Life underwriter or using our laptop or PC underwriting
guide before sending us a potentially difficult case can help).
If we have offered terms
• Go through the actual special terms acceptance letter in
• Explain how we have amended the original application or
what the new premium will be. In some cases we will
have offered two different options.
• Give the customer a copy of the leaflet ‘Special terms –
your questions answered’.
• In some cases the actual special terms acceptance letter
will give the medical reason for our decision.
• If not, ask the customer if they want our Chief Medical
Officer to write to their GP to explain the medical basis
for the terms we have offered. Once requested, we will
do this immediately even if the customer decides to
accept the terms offered.
• Ask the customer to sign and date the bottom of the
special term’s acceptance letter to say whether they
accept the terms.
• Point out to the customer that if they have had any
change of health since they signed their application form
they have a duty to tell us about this change.
• If the customer is not satisfied with the terms we have
offered, explore the other combinations of premium, sum assured or type of cover that may be more acceptable.
You can get quotes for other combinations by e-mailing
or phoning your normal contact.
If we have postponed cover or refused to provide cover
• Explain what this means in terms of the application for
cover, particularly if it was a dual life application.
• Give the customer a copy of either of the leaflets
‘Postponing cover’ or ‘When we have turned down your
application for cover’.
• Remind the customer that in these situations our Chief
Medical Officer will generally have written to their GP to
explain the medical basis for the decision. You should
encourage the customer to speak to their doctor quickly
to see why we have made our decision.
• If we are postponing cover, ask the customer to make sure
that their GP realises that if new relevant details or perhaps
results of extra investigations are provided, we can
sometimes review the decision more quickly than having to
wait until the actual end of the postponement period.
• Discuss any other options or forms of insurance cover that
Will the customer have to tell other life
assurance companies about this decision
Yes, they should give other life assurance companies this
information, as there will usually be a question on the
application form covering this point. The other life assurance
company will make its own decision based on their
assessment of the medical evidence available at that time.
Some details of this customer may be shared with other Irish
Insurance Federation life-assurance companies as a general
protection against any customers who may withhold
important information from a life assurance company.