Story 3 in our 7 Claims Stories series, Misrepresentation Matters, takes a deep dive into one of the most common – and costly – reasons income protection claims are declined: misrepresentation. Whether it’s an innocent mistake, a careless oversight, or something more serious, over 52% of all declined IP claims in 2024 were due to misrepresentation. That’s a staggering figure – and it affects everyone in the industry.
What is misrepresentation?
Misrepresentation is when incorrect, incomplete, or misleading information is provided during an application process. It can have serious consequences for whether a future claim is paid. Most income protection claims are paid in full. However, those that are not, often fail due to misrepresentation, errors or omissions made during the application process. So, why does misrepresentation matter and what is the true cost to the industry? Read our blog to find out more.
Case studies offer a practical way to understand how real-life scenarios are assessed, from the application stage through to a claim decision. These case studies highlight the differences between innocent, deliberate and careless misrepresentation, and how each one can impact the outcome of a claim.
A Different Perspective: Exploring Emerging Technologies in Misrepresentation Management
As part of the broader conversation around misrepresentation in income protection, it’s important to consider a range of approaches being developed across the industry. One such example comes from empath-AI.co.uk, who explain how biomarker technology could be applied to address some of the challenges faced, particularly around mental health, cognitive assessment, and claim integrity.
While this is not an IPTF-endorsed view, it offers an interesting view into how AI-driven tools might supplement traditional methods and highlights the growing focus on innovation in claims and underwriting practices.
