Life and Health Insurance is often considered to be necessary to avoid future medical costs. However, there is a need to be aware are some legal points and issues in relation to these insurance contracts.
: The consequences of not disclosing a medical history and pre-existing conditions
: The termination of insurance contracts ant the consequences
: The legal grounds of the Insurer to refuse a claim upon your death
: The cash and surrender values
: The default of premium payments and the paid up policy
: Is the insurance benefit inheritable?
: The redemption value of the policy
: Loans against the insured benefit
The above matters will be covered through a number of monthly editions in future Hua Hin Today articles.
In this article we will consider the consequence of not disclosing a medical history which is a substantial matter for the insurance contract as provided in the Civil and Commercial Code, Section 865.
The consequences of not disclosing a medical history and pre-existing conditions
This Section states that “If at the time of making the Contract, the assured, or in case of insurance on life, the person upon whose life or death the payment of the sum payable depends, knowingly omits to disclose the facts which would have induced the insurer to raise the premium or to refuse to enter into the contract, or knowingly makes a false statement with regard to such facts, the contract is voidable.”
Additionally, if such right of voidance is not exercised within one month from the time when the insurer has knowledge of the ground of voidance, or within 5 years from the date of the contract, any such right is extinguished.”
Section 866 states: “If the insurer knew of the facts mentioned in Section 865, or knew the statements to be false, or would have known of them or of them being false if he had exercised such care as may be expected from a person of ordinary prudence, the contract shall be void.”
The above provisions of the law clearly state that hiding or nor disclosing facts may cause the insurer to nullify the contract. This may lead to the contract being void from the beginning and the insurer refusing to pay for anything, including medical costs, except refunding the redemption value of the policy to the insured as provided in the Civil and Commercial Code, Section 892.
However, if the insurer does not nullify the contract within a certain period of time as stated in Section 865, paragraph 2 and Section 866, the insurer has to cover all the costs throughout the term of the insurance. There are frequent disputes and court cases between the insurer and the assured related to this matter.
For any questions or more information about insurance please email us at the address below:
© Jatupon Cherbangkaew
Executive Partner / Chief Lawyer
Website : www.actahuahin.com