Mr. William Prasifka:

The first question related to our experience dealing with exclusion clauses and this is something we do on an everyday basis. We fully understand the difficulty that some people face as they believe that when they buy a critical illness policy and something happens, they will get paid. People learn, on reading policies, that only certain types of illness are covered and some of the definitions are very technical. We go through these matters on a case-by-case basis and we first examine what the contract says.

In terms of disclosures, the common law rule in Ireland is one of uberrima fides. The contract of insurance is one of utmost good faith. There is an obligation of disclosure but there is also an obligation on the financial service provider to ask the right questions. We have had a number of cases where financial service providers were claiming non-disclosure in circumstances where they had simply failed to ask the relevant questions properly or clearly enough in order to place the burden back onto the customer. This is a matter with which we deal all the time. Ultimately, what we want to happen is not for us to be obliged to uphold more complaints but rather for standards to be raised. What needs to be done in some of these areas is that more information must be provided at point of sale so that people will be better informed when they are buying the product. That is why we are taking some degree of satisfaction from an overall drop in the number of complaints, particularly if this is an indication that standards are improving. One element of better performance is for providers to settle more cases after complaints have been made. An even better way of dealing with the situation is to obviate the need for people to make complaints as a result of providers changing their practices. We have seen some progress in this regard. We take a very firm view that the burden must be on the provider to ask the correct questions and to do this in a way that is understandable.