BRIEF FACTS:

• The Plaintiff [“Rosalind”] submitted a medical insurance claim to the 1^st Defendant [“Great Eastern”] under a policy she purchased in July 2018.
  
  
• The policy was later repudiated and rescinded by Great Eastern on grounds that Rosalind didn’t disclose her medical history (specifically bronchitis and GERD) which she was diagnosed with in 2017.
  
  
• There was a specific question in the proposal form which asked if Rosalind was ever diagnosed with a respiratory condition like bronchitis and digestive conditions like “gastroesophageal reflux disease” [GERD].
  
  
• Rosalind answered NO to the question posed above.
  
  
• Rosalind claimed she had disclosed her full medical history to the 3rd Defendant [“the insurance agent”] and blamed the 2nd and 3rd Defendants [“the insurance agents”] for not including the information in the proposal form.
  
  
• She also alleged she was induced by the insurance agent to surrender her prior Prudential policy with better coverage.
  
  
• Rosalind then sued Great Eastern and their insurance agents seeking reinstatement of the policy, payment of her hospital bills (RM20,327.90), and general damages for distress.

DECISION OF THE HIGH COURT (HC)

• The HC noted that Rosalind did not disclose her bronchitis and GERD despite being clearly asked in the proposal form.
  
  
• The HC was of the view that Rosalind’s version of events (claiming she gave medical reports to the agent) was found not credible.
  
  
• Rosalind failed to provide those records even when asked again during the claims investigation, as such, there were contradictions in her testimony.
  
  
• Therefore, the HC held that Rosalind’s conduct showed a pattern of concealment.
  
  
• The HC stated that the duty of disclosure lies with the consumer (Rosalind), and this duty is codified in the Financial Services Act 2013.
  
  
• Fraudulent intent was inferred based on the circumstances and omissions.
  
  
• The HC ruled that GE was within their rights to repudiate and rescind the GE policy.
  
  
• Additionally, there was no evidence in support of Rosalind’s claim that the insurance agent told her to surrender her previous policy.
  
  
• In light of the above, the HC held that no negligence was proven against the agents.