Life cover: what you must tell the insurer, and what happens if an answer is wrong

An insurer may ask about your health, habits and income because it has to judge the risk before it agrees to pay out. If an answer turns out to be wrong or missing, Rule 21 of the Policyholder Protection Rules says it counts against you only if a reasonable, prudent person would see it as material to the risk.

What does a life cover insurer ask, and why?

A life cover policy pays a sum of money to the people you name if you die. Before an insurer promises that, it wants to know how likely it is that it will have to pay, and when. That is called underwriting. The questions are the insurer's way of pricing and accepting the risk.

Insurers typically ask about your age, whether you smoke or vape, your general health and medical history, your occupation, your income and whether you take part in dangerous activities. The exact list differs between licensed providers, and it can change with the amount of cover you ask for. The provider that calls you will tell you which questions apply to your application, and whether it needs anything beyond your answers, such as a medical check that it arranges.

Income is on the list for a different reason. The insurer needs to see that the amount of cover makes sense for the life being insured. It is not a credit check. Our life cover hub sets out the basics of what the product pays.

Olvian does not ask these underwriting questions on a provider's behalf and does not decide anything about your risk. We collect a few details so a licensed provider can call you. The provider asks the rest.

Is an insurer allowed to collect your health information?

Yes, within limits. Health information is "special personal information" under the Protection of Personal Information Act (POPIA), and section 26 of that Act forbids processing it in general. Section 32(1)(b) creates an exception for insurance companies, medical schemes, medical scheme administrators and managed healthcare organisations, where the processing is necessary for:

• assessing the risk to be insured, as long as you have not objected to the processing;
• performing the insurance agreement; or
• enforcing contractual rights and obligations.

Section 32(2) says the information may be processed only by parties that are under a duty of confidentiality, whether by their office, employment, profession or the law, or by a written agreement with you. Section 32(3) adds that a party without such a duty must still treat the information as confidential, unless it is required by law or in the course of its duties to pass it on to others who are authorised to process it.

In plain terms: the insurer may use your health answers to assess the risk and run the policy, and it must keep them confidential. The exception for assessing the risk is tied to your not having objected to the processing.

What if an answer is wrong, or you leave something out?

This is the question most people worry about, and the Rules deal with it directly. Rule 21.1 of the Policyholder Protection Rules (Long-term Insurance), 2017 says that, whatever the policy itself says:

• the policy must not be invalidated;
• the insurer's obligations must not be excluded or limited; and
• your obligations must not be increased,

because of an untrue representation or a failure to disclose information, even if you warranted that your answers were true and correct. The one exception is where a reasonable, prudent person would consider the untrue statement or the non-disclosure as likely to have materially affected the insurer's ability to assess the risk when the policy was issued or varied.

Rule 21.2 then explains materiality. A representation or non-disclosure is material if a reasonable, prudent person would consider that the information should have been correctly disclosed so that the insurer could form its own view of how it affects the risk.

Two points follow from the wording. First, the test is about the effect on the insurer's assessment of the risk, not about whether you meant to mislead. Second, the Rules do not hand out a list of "safe" omissions. Whether a particular fact was material is decided on the facts of each case, by the insurer first and, if you dispute it, by an ombud or a court.

The safest approach is the plain one. Answer each question completely and truthfully, and if you are not sure whether something is relevant, say so when the provider asks. The provider or adviser who calls you can tell you how it treats a particular condition. Olvian cannot.

Does the insurer have to ask the right questions?

For funeral policies and microinsurance policies, Rule 2A.8.3 says an insurer may not repudiate a claim on the basis of non-disclosure if it did not specifically ask for that information before the policy began. That rule is written for those policy types. It does not appear in Rule 21, which is the general rule. Our guide on how life cover differs from funeral cover explains where the two sets of rules part ways.

You are also entitled to see how the insurer recorded your answers. Rule 11.5.1(j) says that, at the earliest reasonable opportunity and no later than 31 days after the policy starts, the insurer must give you in writing, among other things, "the representations made by or on behalf of the policyholder to the insurer which were regarded by that insurer as material to its assessment of the risks under the policy". It must also give you evidence of cover and comprehensive details of all exclusions and limitations, and a copy of the policy within the same 31 days (Rule 11.5.3).

Read that list of representations when it arrives. If something is recorded wrongly, tell the insurer in writing straight away and keep a copy of what you sent.

What happens if your age was stated wrongly?

Age is treated separately from other facts. Rule 21.3 says that where the age of a life insured was stated incorrectly, the policy benefits must be those that the premium payable would have provided had the age been stated correctly. The policy is not voided for a wrong age; the benefit is adjusted.

Rule 21.4 adds a safety valve. If the nature of the policy makes that arrangement inequitable, the regulator (the Rules call it the Authority) may direct the insurer to use a different method of adjusting the benefits, whichever it considers equitable in relation to the misstatement of age.

Can you cancel after the policy starts?

Possibly, within a short window. Rule 4.2 allows a policyholder to cancel a new policy, or a variation of it, by sending a cancellation notice to the insurer within 31 days after receiving the information described in Rule 11.5, or a reasonable date on which you can be taken to have received it. Two conditions apply: no benefit has been paid or claimed, and the event insured against has not yet happened. Policies with a duration of 31 days or less are excluded.

Rule 4.3 says the insurer must refund all premiums and other money you paid up to the cancellation notice, and any received after it, less the cost of any risk cover you actually enjoyed and any market loss where investments were made. For a plain risk policy the second deduction is unlikely to arise. Rule 4.4 gives the insurer 31 days from the notice to carry out the cancellation. Rule 4.7 says the cooling-off rule applies only to new policies and to variations of existing ones.

Rule 4.5 adds that if a policy cannot be cancelled by law, or by its nature, the intermediary or insurer must tell you before you enter into it.

Cooling-off is a right to leave, not a reason to rush in. It is no substitute for reading the policy schedule and the exclusions before you agree.

What should you have ready before the insurer calls?

You do not need documents to ask for a call. It helps to have the following in your head or to hand, because the provider will probably ask:

1. Your date of birth and the dates of birth of anyone else to be covered.
2. Whether you, or anyone to be covered, smoke or vape, and when you last did.
3. Any conditions you have been treated for, any medicine you take regularly and the dates of any hospital stays.
4. Your occupation and your monthly income.
5. Any existing life cover, so that the provider can understand what you already have.
6. Who you would like to name to receive the money, with their details.

If you do not know an answer, say that. A confident wrong answer is worse than "I will check".

How does Olvian fit in?

Olvian is a lead-referral service. You tell us once what you are looking for, and we pass your request to licensed providers who pay Olvian a fee. They call you back. We do not give financial advice, we do not recommend an amount of cover or a provider, and we do not decide what you are offered. Questions about your answers, the risk and the price are for the licensed provider or adviser who calls.

Sources

Checked on 31 October 2026. Olvian is not a financial services provider and this guide is information, not advice.

• Policyholder Protection Rules (Long-term Insurance), Rule 21: misrepresentation, inserted by Notice 997, Government Gazette 41928, 28 September 2018.
• Rule 11.5: disclosure after inception of policy
• Rule 4: cooling-off rights
• Rule 2A.8: claims under microinsurance and funeral policies
• Protection of Personal Information Act 4 of 2013, section 32: authorisation concerning health or sex life
• Financial Sector Conduct Authority: market conduct regulator, including the search for authorised financial services providers.