White Baos Lawyers has an extensive and successful experience in assisting our clients to claim a life insurance policy. In today’s article we would like to share with our readers a new court success of our firm. A claim filed against an insurance company that refused to pay the 150,000€ compensation set out in the policy that the widow of the deceased was entitled to. If you want to read the full judgement, please click here.
The health questionnaire: an essential document.
One of the most important documents when taking out a life insurance policy is the health questionnaire. This document consists of a series of questions about the policyholder’s health: having suffered from previous illnesses, having medical tests pending, being under treatment of certain medications, being a smoker, etc.
When the policyholder dies due to an illness, the first step for the insurance company will be to compare the medical history of the deceased with the questionnaire that was signed by him/her when the insurance was taken out. So that if the deceased omitted any illness or pathology that could be related to his/her death, the insurer will refuse to pay the corresponding compensation. In summary, to claim a life insurance policy, in the event of death due to an illness, this document is of the utmost importance.
The case as argued.
In March 2019, Mr “J” went to a well-known private hospital to request a blood test. He did so of his own free will and without presenting any health problems. The doctor who attended him also ordered a chest X-ray. And the results of both tests were correct. The X-ray showed absolutely normal values, and the cholesterol levels were “very low”. No further tests were ordered, and no medication was prescribed. He was only given a generic recommendation (applicable to almost everyone): to exercise from time to time and a to keep a healthy diet.
Life insurance contract, sudden death and the insurance company’s refusal to pay.
A month later, by the end of April 2019, Mr. “J” took out a life insurance policy, naming his wife as the beneficiary. Sadly, 4 months later he passed away due to a sudden heart attack. The insurance company refused to pay the compensation, arguing that it had been hidden in the health questionnaire that the deceased had cholesterol. And that there were pending medical tests which the deceased failed to report in the questionnaire.
First Instance Judgment and appeal to the Provincial Court of Alicante.
The Court of First Instance dismissed our client’s claim and ruled in favour of the insurer. However, we appealed the decision to the High Court of Alicante, convinced that our clients were entitled to compensation. On appeal, we were able to prove that the medical report submitted by the hospital (indicating that there were pending medical tests) was issued after the death. In other words, the tests were not properly prescribed to the patient prior to his death. Therefore, there was no concealment whatsoever. As requested by our firm, the Provincial Court of Alicante has ruled that the insurer must pay the compensation of 150,000€ to the widow of the deceased.
Conclusions
If an insurance company refuses to pay compensation for the life insurance of a family member, do not hesitate to contact us. At White-Baos we are experts in legal claims. We will study the viability of your case, and we will offer you expert legal advice on how to claim a life insurance.
The information provided in this article is not intended to be legal advice, but merely conveys information relating to legal issues.
Carlos Baos (Lawyer)
White & Baos.
Tel: +34 966 426 185
E-mail: info@white-baos.com
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