Seguradora isenta de pagar indemnização por doença oculta? Saiba como se prevenir

Insurer not liable to pay compensation for hidden disease? Learn how to prevent yourself

The insurance company was acquitted of paying compensation to the insured's daughter who was diagnosed with cancer shortly after the contract was signed. The Court ruled in favor of the insurance company, stating that the insured already had symptoms indicative of the disease, which were not disclosed in the pre-contract health questionnaire. Understand what is at stake.

13 Mar 20244 min

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Want to hire insurance? Contact the credit intermediaries of Poupança no Minuto and guarantee support and advice for this process! But read this case and learn how to protect yourself from similar situations.

Court rules in favor of insurer claiming hidden illness on the part of the client.

According to the Jornal de Notícias, the Court of Appeal in Coimbra ruled in favor of the insurance company in a case where the client withheld information about an illness.

The insurance company was acquitted of paying a claim for compensation of 50 thousand euros plus interest for life insurance, requested by the daughter and only heir of the insured. The entity argues that it was not aware of the unhealthy health condition of the client at the time of contracting the agreement.

At the time of signing the contract, the policyholder guaranteed to be in perfect health, without any medical evaluation, thus omitting that she had presented, a month before, symptoms "of relevance and significance" that required her to resort "multiple times" to emergency services and a general and family medicine consultation, according to the news.

The insured eventually passed away three months later, and her daughter filed a lawsuit in court after the insurance company refused to pay compensation, as it claimed "nullity or unenforceability of the contract due to the false or inaccurate statements that the mother... made when she signed the membership form where she declared being in perfect health, omitting the existence of the diseases she knew she suffered from," as mentioned in the news article.  

The insured's daughter argues that her mother provided all the information she knew at the time of contract celebration, not yet having a diagnosis of the disease, liver cancer, nor a way to predict "the fulminant and invasive disease that led to her death". However, the Viseu Court, to which she initially appealed, states that the insured provided "inaccurate and intentionally misleading statements regarding her health condition, with omission of relevant information that prevented the defendant (insurer) from assessing the risk and that, had they been aware of it, would have led to the refusal of contract celebration".

It was after this decision that the client's daughter appealed to the Court of Appeal of Coimbra, but without success, since it was considered proven that "the insurer would not have entered into the insurance contract had it been aware of the information that was omitted", and that it was the responsibility of the insured to inform about all circumstances of her health condition, in this case the initial symptoms that had already been detected.

The daughter considers there to have been an abuse of rights, not confirmed by the judges who indicate that the insurer only became aware of the hidden information after the communication of the illness.    

Prevent these cases: Learn the importance of the health questionnaire and an insurance mediator.

How to protect yourself from a similar situation? The health questionnaire to be filled out prior to the insurance contract should be as detailed as possible.

If you have symptoms, even if they are not very relevant, of any indication of a disease, you should describe them in the health questionnaire. Because in case of being diagnosed with a disease after the contract has been signed, you can claim that you informed the insurer about all the information you were aware of at the time.

It may happen that the insurance company increases the premium to be paid due to symptoms indicative of a pre-existing illness, or it may not accept it at all, so in order to contract the insurance, proposals from several entities are required.

To ensure support throughout the entire process, it is important to have an insurance mediator with you for better negotiation with insurers and advice on these issues.

This type of services is free of charge and can help you protect yourself in these legal cases. If you are looking to hire insurance, contact the insurance mediators from Poupança no Minuto and ensure a hassle-free process!

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