Insurance contract law you should know before signing

Yes. Section 865 of the Civil and Commercial Code makes the contract voidable where the insured knew facts that would have led the insurer to charge a higher premium or to decline the risk and concealed them or made a false statement. The insurer may avoid the contract within one month of learning the ground and within five years of the contract date. Complete the application form yourself and truthfully rather than leaving it to an agent.

Section 882 of the Civil and Commercial Code sets two years from the date of the loss for claiming indemnity, and two years from the due date for claiming premium. If negotiations drag toward the two-year mark, take legal advice on filing suit or on steps that interrupt the limitation period — do not rely on the insurer's internal review alone.

Standard health policies exclude conditions existing before cover starts and impose waiting periods for certain groups such as cataract, stones and tumours, all listed in the exclusions section. These terms bind as contract terms so long as they appear in the policy wording approved by the Registrar. Read the schedule and endorsements rather than the marketing leaflet before buying.

Yes, though many plans cap the insured age and exclude treatment arising from pre-existing conditions. Read the exclusions and look for plans offering a chronic-condition extension. Carry a medication list and an English-language medical certificate, because the insurer's assistance centre will ask for clinical details before approving cashless treatment abroad.

Ask for the refusal in writing with the reason and the policy clause relied on, then compare it against the schedule's conditions and exclusions. Appeal internally with further evidence such as your treating doctor's opinion. If that fails, complain to the OIC. Keep dated copies of every exchange: they are evidence and they help you manage the two-year limitation period in section 882.

Most health policies exclude conditions existing before the cover start date, or cover them only after a stated waiting period. Failing to disclose health facts in the application can allow the insurer to avoid the contract under the Civil and Commercial Code. Disclose accurately and keep a copy of your application.

Under the Civil and Commercial Code an insurance contract is voidable where the insured knew and concealed a material fact that would have led the insurer to charge a higher premium or decline the risk. The insurer must exercise avoidance within one month of learning of the ground and in any case within five years of the contract date. Beyond those limits, or where the insured genuinely did not know the fact at the time, avoidance is improper. Ask for the reasons in writing and keep medical records showing the first date of diagnosis.

First obtain a written declination citing the policy clause and reasons, then use the insurer's complaints channel. If unresolved, complain to the Office of Insurance Commission through the 1186 hotline or the online intake, attaching the policy, the declination letter, treatment records and receipts. The Office operates mediation and arbitration procedures that are faster and cheaper than litigation. The general limitation period for suing on an insurance contract is two years from the date of loss.

The common ones are notifying the insurer without delay as the policy requires, submitting claim documents within each policy's deadline, the insurer's right to avoid the contract within one month of learning the ground and no later than five years from inception, and the two-year limitation period for suing on an insurance contract from the date of loss. Claims for initial compensation under the Road Accident Victims Protection Act have their own separate deadline. Record the incident date and every filing date.

Standard OIC approved health policies exclude conditions existing before the policy started and impose waiting periods, commonly 120 days for conditions such as tumours and stones. Applicants must disclose their medical history truthfully: non-disclosure allows the insurer to void the contract within two years of inception under the Civil and Commercial Code and to refuse the claim.

The condition itself is not disqualifying. The risk is an exclusion that leaves effective coverage below the required limit, or wording that excludes inpatient care entirely. Choose a plan that accepts the risk after a waiting period, or attach a doctor's letter showing the condition is controlled together with proof of remaining coverage.