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Consumer Insurance Contract Act & AIG

The Consumer Insurance Contracts Act 2019 (CICA) was signed into law on 26 December 2019.  All sections of CICA will become CICA effective from 1 September 2021 and apply to all new policies or renewals which become effective on or after the 1 September. The obligations and rights under CICA will be applicable to customers who are classified as consumers (see definition below).

At AIG we put you, as the consumer, at the heart of everything we do – providing you with all the information in a clear and transparent manner, and with all our dealings with consumers we aim to treat you with fairness and efficiency in mind. With this in mind we have prepared the below summary of the new protections, rights and obligations of both insurers and consumers that will be provided under CICA. 

You can read CICA at: http://www.irishstatutebook.ie/eli/2020/si/329/made/en/print

 
 

 

Summary Overview:

CICA aims to provide consumers with greater protections and ensure that insurance policy documents (including pre-contract of insurance application forms) are provided in a clear, plain English and transparent manner. CICA will change the manner in which consumer insurance business is conducted in Ireland, with new duties and responsibilities now required of both insurers (AIG) and consumers.

 

For AIG, our pre-contract of insurance application processes have been refreshed to ask consumers only specific questions concerning the proposed insured, the policy and insurable risk. In addition, policy wordings and related insurance cover documentation will be updated to incorporate specific insurer obligations under CICA, for example, remedies for misrepresentation.

 

For consumers, their pre-contractual disclosure obligations have been changed. CICA removes the duty to disclose all material facts on consumers and replaces it with an obligation for consumers to answer all questions the insurer asks honestly and with reasonable care. Failure to do so can result in the Insurer being able to rely on proportionate remedies for misrepresentation. 

 

 
 

Proportionate remedies that insurers can rely on for misrepresentation are now categorised under 3 headings:

 

(a)    Innocent misrepresentation (i.e. neither negligent nor fraudulent)

Where an innocent misrepresentation by a consumer has taken place, an insurer may not avoid paying a claim.

 

(b)    Negligent misrepresentation

Where a negligent misrepresentation by a consumer arises, an insurer has a number of potential remedies available dependent upon whether (a) the insurer would still have entered into the insurance contract or (b) whether the terms would have been different.

The approach required of insurers in such an instance shall be based on a compensatory and proportionate test.

If an insurer would not have entered into the insurance contract on any terms, then the insurer may avoid the contract and refuse all claims. However, premium amounts paid by the consumer will be returned.

However, if the insurer would have entered into the insurance contract on different policy terms (excluding terms relating to the premium), then the insurer can treat the contract as being valid on those different policy terms, if the insurer so requires.

Lastly, if the insurer would have entered into the insurance contract but at a higher premium charge, then the insurer may reduce proportionately the amount to be paid on any claim.

 

(c)  Fraudulent misrepresentation

In instances of fraudulent misrepresentation, an insurer can avoid the contract of insurance and the payment of any claim.

 

Who is defined as a Consumer under CICA?

CICA applies to insurance contracts with individuals, unincorporated bodies (e.g. sole traders, partnerships and charities), and incorporated bodies/businesses with a turnover of less than €3m in the last financial year, provided such businesses are not members of a group with a combined turnover greater than €3m.

 

As an AIG customer, what changes will I see?

We have updated our insurance policy wordings, cover documentation, new cover application and renewal application processes, to comply with this legislation, starting with insurance cover periods effective from 1st September 2021 onwards. The changes you will see include:

            

1. Our pre-contract of insurance application processes have been enhanced so we now ask you specific questions in a clear and plain English manner.

2. Your insurance cover confirmation documents, whether for a new cover inception or for renewal of an existing AIG policy, will now incorporate your latest completed application form (previously known as a statement of fact) answers or information provided by you. We will provide you with all your policy documents, including your completed application form, in a durable medium, for you to check, retain and to refer to in the future, as required.

3. Policy renewal invitation documentation packs will now include a summary of your premium and claims for at least the last 5 years.

4. Policy wording booklets and Insurance Product Information Documents (IPIDs) have been updated to incorporate your rights and your obligations under CICA.

5. Our claims handling and policyholder communication processes have been enhanced to reflect our obligations under CICA.

6.  You just need to remember that you must contact AIG immediately (or your intermediary if your AIG policy arranged through an intermediary), if any of the answers or information provided is inaccurate or has changed beyond what was reasonably contemplated when the contract of insurance was originally concluded.

7.  CICA clarifies that any statement by a consumer with respect to the existence of a state of affairs or a statement of opinion shall be treated as a representation by the consumer and shall not be treated as an 'insurance warranty' as is commonly the case currently.

 

If you have any questions in respect of how CICA may affect your policy from 1 September 2021, please get in touch with the appropriate AIG point of contact (see contact details on your policy documents) or your broker.