Website terms

Intended audience and territory

The Expacare site is intended to provide information and assistance to expatriates with international healthcare needs.

Please refer to membership guides for further information.

Code of conduct

Expacare Limited is governed by The Financial Conduct Authority.

Further information can be found at www.fca.org.uk

Website cookies

See our Cookie Policy Page.

Privacy policy

See our Privacy Policy

Duty of disclosure

Information that you provide to us – for consumer contracts

If you are an individual covered by our plan or an individual buying insurance outside your trade, business or profession, you must take reasonable care to answer all the questions asked by the Insurer and us in connection with your insurance, whether through a proposal form or otherwise, honestly and to the best of your knowledge, and provide complete and accurate answers. If you make a misrepresentation to the Insurer (whether innocently or otherwise), the Insurer may impose additional policy terms, or reduce a claim payment, or even to cancel the policy and refuse all claims. If you make a deliberate or reckless misrepresentation, the Insurer may cancel the policy and refuse all claims, and in these circumstances the Insurer will be entitled to retain any premium paid by you. You should note that failure to comply with a request at renewal to confirm or amend particulars you have previously given may amount to misrepresentation which could prejudice your insurance cover in whole or in part. Where guidance is provided in relation to a question please ensure that you read this fully to ensure the correct answer is provided.

If you are in any way uncertain about any of the questions asked, please seek further clarification from your broker or from us. 

Duty of Fair Presentation – for business contracts

If you are an individual purchasing or renewing insurance in connection with your business, trade or profession, or you are a sponsoring organisation purchasing or renewing a Group Policy or a Corporate Advantage Plan Policy, you must be aware of the duty of fair presentation. This obliges you to provide accurate answers to all questions. Failure to comply with this obligation may entitle the Insurer to decline your claim, pay a proportionate amount of your claim only, or cancel your policy.

The duty of fair presentation, in relation to questions asked by the Insurer, is a duty to provide to the Insurer:

• details of material circumstances which the insured person knows or ought to know, or
• failing that, answers which give the Insurer sufficient information to put a prudent Insurer on notice that it needs to make further enquiries for the purposes of revealing those material circumstances.

A material circumstance is one which would influence the judgment of a prudent Insurer (not necessarily the Insurer in question) in determining whether to take the risk and, if so, on what terms. Examples of such circumstances could be any ongoing serious medical conditions, or planned or pending medical treatment. Please note that these examples are for illustrative purposes only and are by no means exhaustive or

conclusive.

It is important to understand who in your business has “knowledge” for the purposes of this duty:

• If you are an individual buying cover in connection with your business, you will be presumed to know what you actually know and what is known by the individuals responsible for your insurance (such as your broker);
• If you are a corporate entity, you will be presumed to know what is known by the business’s “senior management” and the individuals responsible for its insurance (such as your risk management team and your broker). Senior Management means those individuals who, in connection with the risks to be insured, play significant roles in the making of decisions about how the insured person’s activities are to be managed.

We will seek to agree with the Insurer in advance of any placement whose “knowledge” counts for the purposes of the duty, and will in any event provide you with guidance on this.

Please note that you will be treated as knowing:

• material circumstances of which you (or the relevant persons identified above) have actual knowledge;
• material circumstances which you suspect but you have deliberately refrained from confirming or enquiring about;

and

• material circumstances about which you ought to know (i.e. circumstances which should reasonably have been revealed by a reasonable search of information available to you).

This means that in some circumstances the responsible individuals will be required to make enquiries, and the information (and therefore the scope of those enquiries) may not necessarily be limited to that held by the business. We will provide advice and guidance on the nature and extent of searches that may be required to comply with the duty. The duty of fair presentation continues up until the insurance has been concluded and ‘resurrects’ in the event of any amendment to the risk during the policy period or extension/renewal. It may also be that the terms of the policy include specific ongoing disclosure conditions or conditions which effectively extend certain disclosure obligations post inception of the policy. In completing a proposal or claim form or any other material document relating to an insurance policy and in providing information to or for the Insurer, the accuracy and completeness of all answers, statements and/or information is the policyholder’s own responsibility and it is of paramount importance that all relevant information is provided and that it is accurate. Should you so require, you may request that we assist you by providing examples of the sorts of matters which ought to be disclosed as being material or arguably material circumstances, in general terms, or specific to your risk from the knowledge we gain from working with you to understand your risk. In the event that there is a breach of the duty of fair presentation, Insurers are generally limited to “proportionate remedies”, linked to what they would have done if the risk had been fairly presented. This may result in the imposition of different terms, or the proportionate reduction of claims where a higher premium would have been charged. In circumstances where Insurers would not have entered into the contract on any terms they can avoid the contract and refuse all claims, but must return the premium. If the breach is deliberate or reckless Insurers can avoid the policy, refuse all claims and keep the premium.

If you are in any doubt as to the scope of the duty of fair presentation or whether a piece of information ought to be disclosed, please do not hesitate to contact your broker or us.

Compensation

Expacare Limited are subject to the Financial Services Compensation scheme in the United Kingdom. Please see www.fscs.org.uk for further information.

English law applies to any conflict or dispute relating to this plan, and conflicts and disputes will only be dealt with by English courts.

Disclaimer

Whilst all reasonable care has been taken in the preparation of this site no liability is accepted under any circumstances by Expacare for any loss incurred as a result of reliance on any statement, error or any omission contained herein.

The statements within this site reflect our understanding of current and proposed legislation, which may change without notice.

The content of this site should not be regarded as specific advice in relation to the matters addressed.