Why life insurance claims get declined in Ireland — and how to make sure yours is not one of them

The headline you do not see in marketing

Irish life offices report life-cover paid rates of 97–99% in 2025. The 2025 mylife.ie whole-of-market claims report confirms that pattern at every disclosing office. What that figure does not say — and what most marketing does not explain — is what happens in the 1–3% that are not paid. The answer is uncomfortable but consistent: the great majority of declined Irish life-cover claims fail because of something the policyholder did or did not say when they applied, not because the insurer decided at the claim stage to refuse payment.

Irish Life states explicitly that material non-disclosure is the main reason death claims are not paid. New Ireland disclosed three declined death claims in 2024 — all three on non-disclosure grounds. The 2025 dataset shows the same pattern across the disclosing offices. Death is a binary event. The certificate is not in dispute. What is in dispute is whether the policy was issued on the basis of an accurate medical, occupational and lifestyle picture.

What “material non-disclosure” means under Irish law

The legal framework is the Consumer Insurance Contracts Act 2019. Section 16 of the Act sets the modern Irish standard. A consumer is required to answer the specific questions an insurer asks, honestly and with reasonable care. The old common-law duty of “utmost good faith” — which placed an open-ended onus on the consumer to volunteer anything that might be relevant — was deliberately replaced. The duty now runs only to the questions actually asked.

That is a meaningful protection for Irish consumers. But it also raises the bar on what counts as a complete answer. A question about “any consultations with a GP in the last five years” is not satisfied by mentioning some consultations. A question about “any medication taken regularly” is not satisfied by listing the ones that come to mind. The Act gives insurers a graduated response where an answer is incomplete: proportionate remedy where the misstatement was innocent, more significant remedy where it was negligent, contract avoidance where it was deliberate or reckless.

The questions that produce most declines

The 2025 report does not name individual declined cases. What it confirms is the category of question on which most non-disclosure-driven declines turn. The list below is illustrative rather than exhaustive — these are recurring areas where the gap between the applicant’s recollection and the underwriter’s expectation tends to be widest:

• Smoking, vaping and nicotine use. The standard Irish definition typically captures any tobacco or nicotine use in the 12 months prior to application, including e-cigarettes. A "social smoker" who declared as a non-smoker is one of the more common patterns underwriters encounter.
• Family history. Cancer, cardiovascular disease and hereditary conditions in immediate family, with each office setting its own age thresholds and definitions. The thresholds differ enough between offices that the same family picture can produce different ratings.
• Height, weight and BMI. A small understatement is rarely material; an understatement large enough to move the applicant into a different underwriting band can be.
• GP attendances and consultations. A frequent area of innocent omission. Routine visits and consultations are generally material if the application asked for them, regardless of how the consumer remembers the outcome at the time.
• Hazardous pursuits and occupation specifics. A change of role, a new hobby, or an unrecorded second occupation can be relevant depending on how each office's question is framed.
• Alcohol use. Quantified weekly intake; the underwriting question tends to be specific and is generally interpreted strictly.
• Mental-health history. Past consultations, diagnoses or medication, irrespective of whether the consumer considers themselves currently well.

The honest, defensible answer to each of these is the answer that supports a paid claim. The optimistic answer is the answer that does not.

What changed in 2019, and what it means for a 2026 buyer

The Consumer Insurance Contracts Act 2019 §16 is the framework the courts apply to any Irish life claim where non-disclosure is alleged. Three points matter for a consumer buying cover in 2026.

First, the duty is to answer the specific question asked. If the application form does not ask about a fact, the consumer is not under a duty to disclose it. This is a real consumer protection — but it means the framing of the question, and the completeness of the answer, are what the insurer is entitled to rely on.

Second, the test is honest and reasonably careful. Not perfect. A reasonable degree of effort to provide a complete answer — checking dates, checking GP records where relevant — is the standard. Forgetting an item that a reasonably careful person would not have forgotten is not.

Third, the insurer’s response to a non-disclosure is graduated. Innocent misstatement attracts proportionate remedy. Negligent misstatement attracts a more significant remedy, including avoidance of certain claims. Deliberate or reckless misstatement attracts avoidance of the policy and refund of premiums only. The 1–3% of Irish life claims that are not paid generally fall into the second and third categories.

How to make sure your claim is paid

The single most effective protective step is taken before the policy is even issued. Three habits separate paid claims from the small remainder.

Take time over the application. A protection application is not a comparison-engine quote. Treat each question with the assumption that the answer will be scrutinised at the claim stage — because it will be, on the small number of cases where it matters.

Ask your GP for a summary. A two-page summary of consultations in the relevant lookback period costs little and produces a complete picture. It is the single most reliable way to avoid an innocent omission on the GP-attendance question.

Use a broker that pre-underwrites your case against the whole market. mylife is a whole-of-market broker — but more than that, our pre-underwriting system understands every Irish protection contract in granular detail. We match your individual medical, occupational and lifestyle picture to the policy that best fits it, and only then overlay pricing and other factors to arrive at a recommendation. What matters is best fit, and mylife’s ability to do that at a standard far ahead of any of our competitors is what sets us apart. A single-channel quote cannot replicate it; a comparison engine that prices five offices on the same inputs cannot replicate it either.

The 2025 claims report confirms the underlying point. Irish life offices pay claims. What stops a claim from being paid is almost always upstream of the claim form. It is on the application.

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