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Proportionate remedies and claims handling
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18. (1) Where a claim made by a consumer under a contract of insurance contains information that is false or misleading in any material respect and which the consumer either knows to be false or misleading or consciously disregards whether it is false or misleading, the insurer shall be entitled to refuse to pay the claim and shall be entitled to terminate the contract.
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(2) A valid claim made under a policy is not affected where, under the same policy, the consumer makes a subsequent fraudulent claim or where fraudulent evidence or information is submitted or adduced in its support.
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(3) Where an insurer becomes aware that a consumer has made a fraudulent claim, the insurer may, as soon as is practicable after becoming aware of that fact, notify the consumer on paper or on another durable medium that it is avoiding the insurance contract, and if the insurer so notifies the consumer, the insurance contract shall be treated as having been terminated with effect from the date of the submission of the fraudulent claim (referred to in this subsection as “the date of the fraudulent act”), whereupon—
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(a) the insurer may refuse all liability to the consumer under the insurance contract in respect of any claim made after the date of the fraudulent act, and
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(b) the insurer need not return any of the premiums paid under the insurance contract.
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(4) (a) Where a contract of insurance contains a term or condition excluding coverage for loss or damage to property caused by a criminal or intentional act or omission of a consumer or any other person, the exclusion applies only to the claim of a person—
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(i) whose act or omission caused the loss or damage,
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(ii) who abetted or colluded in the act or omission, or
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(iii) who consented to the act or omission and knew or ought to have known that the act or omission would cause the loss or damage.
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(b) Nothing in paragraph (a) shall be interpreted as allowing a person whose property is insured under the contract of insurance to recover more than that person’s proportionate interest in the lost or damaged property.
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(c) A consumer whose coverage under the contract of insurance would be excluded but for paragraph (a) shall cooperate with the insurer in respect of the investigation of the loss, including—
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(i) by submitting a statutory declaration if requested by the insurer, and
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(ii) by producing for examination at a reasonable time and place designated by the insurer documents specified by the insurer that relate to the loss.
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(5) An insurer shall not be entitled to claim against the consumer the cost of investigating a fraudulent claim.
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