According to the Financial Supervision Commission, the revenues of life insurance companies selling “Life Insurance” in Bulgaria exceed 700 million leva for 2023. The number of lawsuits under these insurances is also increasing. An experienced lawyer is increasingly needed in this matter.
Life insurances are voluntary and the risks covered, the risks excluded, the rights and obligations of the parties are determined in the general terms and conditions. Regardless of the above, the subject of this insurance is life, and it is the highest value. Therefore, the legislator has created a regulatory framework that insurance companies should comply with and should not violate.
BEFORE CONTRACTING THE INSURANCE
Before concluding the insurance, an assessment of the risk that the insurer will assume should be made. It is not without importance what the health condition of the applicant for insurance is, his age and other factors that may be relevant to the risk. In certain cases, insurers refuse to bear the risk of natural death. Such are the cases of applicants for insurance in old age.
Before concluding insurance, it is necessary to collect information about the health condition of the individual whose life will be insured. Usually, when the insurance amount is smaller and the insurance is cheaper, a pre-prepared health declaration is filled out by the insurance company. In other cases, it may be required to answer a questionnaire or conduct medical examinations of the insured before concluding the contract.
It is important for the parties to know that inaccurately provided data about the health condition of the insured could lead to a dispute in connection with the insurance. Most often this happens when an insured event occurs.
It is important for individuals interested in “Life Insurance” to familiarize themselves in advance with the risks covered, but also with the exclusions under the insurance and to assess whether the specific insurance meets their needs. Of course, the persons who sell insurance products have legal obligations to assist the applicant for insurance in this regard, but our advice is that when concluding insurance for property of significant value, an independent investigation should be carried out.
IF AN INSURANCE EVENT OCCURS / advice of Lawyer Zdravkov:
When a covered risk occurs, it is necessary to comply with the obligations under the concluded contract. The insurer has the right to establish the reasons for the event. The insured or his heirs should cooperate at this stage.
Often, disputes arise between the parties regarding:
– The reasons for the event;
– Compliance with the obligations that the persons had before the event occurred;
– The insurer’s right to refuse payment of the insured amount.
The reasons for the event are particularly important, since they are the basis for assessing whether an event is actually a covered risk or not. The cause of death is not without importance, for example, if the general terms and conditions of the insurance stipulate that the insurer is not liable for events that occurred as a result of certain diseases.
Disputes also arise regarding the proof of claims that the event is not a covered risk under the insurance. In this regard, case law is diverse, which makes it even more important to analyze the terms and conditions of the insurance before concluding it.
CLARIFICATION
The insurance terms and conditions may meet the requirements of the insured person, the information requested by the insurer may be filled in correctly, but upon the occurrence of an event, a dispute may arise again regarding the liability of the insurance amount. Insured persons should be aware that under Life insurance, the statute of limitations for filing a claim before the court is 5 years from the occurrence of the insured event. Filing a voluntary claim suspends the statute of limitations until the date of receipt of the response or until the expiration of the maximum period within which the insurer must make a decision.
Our lawyers have extensive experience in the field of insurance law and resolving disputes in this matter. We have consulted both insurers and consumers.
Do not hesitate to contact us for consultation and assistance on your case:
You can read more information on the topic here: zdravkov-legal.com/zastrahovatelno-pravo
office@zdravkov-legal.com
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