The information under the headings below is set out in the Zurich Community Care Liability Insurance Group Policy Wording.
In that document:
Affiliated care/support worker mean an individual natural person or company or other entity who the policy owner notifies to us for the period of insurance as a person providing approved care work and who:
- has not been referred to us for individual underwriting; or
- has been referred to us for individual underwriting and has been accepted by us as an insured.
Insured includes an affiliated carer
Policy owner means Better Caring Pty Ltd trading as Mable , ABN 80 162 890 379
Duty of Disclosure
Before the policy owner enters into a contract of general insurance with us, the policy owner has a duty under the Insurance Contracts Act 1984 (Cth), to tell us every matter that the policy owner knows, or could reasonably be expected to know, is relevant to our decision whether to provide insurance and whether any special conditions need to apply to the policy.
The policy owner has the same duty to disclose those matters to us before the policy owner renews, extends, varies or reinstates the Policy. The policy owner doesn’t however need to tell us about any matter that:
- diminishes our risk;
- is of common knowledge;
- we know or should know as insurers; or
- that we tell the policy owner we do not need to know.
If we offer to renew this policy, we may give the information about the disclosures that have previously been made and ask the policy owner to tell us if there has been any change to those matters. If the policy owner does not disclose any change to those matters, which a reasonable person in the circumstances would disclose, then the policy owner will be taken to have informed us that there are no changes to those matters.
If the policy owner does not comply with this duty, we may cancel the policy or reduce the amount we pay if a claim is made. If fraud is involved, we may treat the policy as if it never existed, and pay nothing.
In the case of insureds, there is no statutory duty of disclosure which exists. However it is a condition of provision of cover in respect of an affiliated carer under this policy that the policy owner obtain an insurance application from each affiliated carer through the policy owner’s ‘Mable’ website before cover to that affiliated carer is provided and we will not be liable to provide or to pay benefits where there has been misrepresentation or non-disclosure by an insured.
For these purposes we will treat an affiliated carer as if they did owe a duty of disclosure to us and without limitation will exercise any powers in respect of non-payment of benefits or cancellation of cover which we could exercise under the Insurance Contracts Act 1984 (Cth) if an affiliated carer did owe us a duty of disclosure.
Non-disclosure or Misrepresentation
If the policy owner or an insured makes a misrepresentation to us, or if they do not comply with this duty of disclosure and we issue the policy with terms and conditions that are different to the terms and conditions that would have been issued had there not been any misrepresentation, or the policy owner’s or insured’s duty of disclosure had been complied with, then:
- we may reduce the cover provided so that we are placed in the same position as we would have been in, had there not been any misrepresentation
- and the policy owner’s or insured’s duty of disclosure had been complied with; and
- we may also cancel the policy; or
- we may treat the policy as if it never existed if the misrepresentation or the non-compliance with the policy owner’s or an insured’s duty of disclosure was fraudulent.