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Short-Term Insurance Act, 1998 (Act No. 53 of 1998)

Part VII : Business practice, policies and policyholder protection

Policies

53. Misrepresentation and failure to disclose material information

[Section 53 heading substituted by section 35 of Act No. 17 of 2003]

 

(1)
(a) Notwithstanding anything to the contrary contained in a short-term policy, whether entered into before or after the commencement of this Act, but subject to subsection (2)—
(i) the policy shall not be invalidated;
(ii) the obligation of the short-term insurer thereunder shall not be excluded or limited; and
(iii) the obligations of the policyholder shall not be increased,

on account of any representation made to the insurer which is not true, or failure to disclose information, whether or not the representation or disclosure has been warranted to be true and correct, unless that representation or non-disclosure is such as to be likely to have materially affected the assessment of the risk under the policy concerned at the time of its issue or at the time of any renewal or variation thereof.

(b) The representation or non-disclosure shall be regarded as material if a reasonable, prudent person would consider that the particular information constituting the representation or which was not disclosed, as the case may be, should have been correctly disclosed to the short-term insurer so that the insurer could form its own view as to the effect of such information on the assessment of the relevant risk.

[Section 53(1) substituted by section 35 of Act No. 17 of 2003]

 

(2) If the age of an insured under an accident and health policy has been incorrectly stated to the short-term insurer, the policy benefits shall, notwithstanding subsection (1), be those which would have been provided under that policy in return for the premium payable had the age been correctly stated: Provided that if the nature of that accident and health policy is such as to render such arrangement inequitable, the Authority may direct the short-term insurer to apply such different method of adjustment to the policy benefits of that accident and health policy as the Authority considers equitable in relation to the misstatement of age.