Sinusitis need not be disclosed absent relevant questionnaire question

ATA/676/1997Tribunal de Justiça / Câmara Administrativa4 de nov. de 1997

Extraído pela Omnilex

Resumo Omnilex

The court held that an insured person who had recently suffered from sinusitis but was no longer affected did not have to mention it in an insurance questionnaire that did not refer to that kind of illness. If the sinusitis only became chronic after the insurance contract was concluded, there is no reticence within the meaning of Art. 4 LCA.

Sumário Omnilex

Art. 4 LCA; duty to disclose in insurance questionnaires and reticence: only facts within the scope of the insurer’s questions must be declared. A past ailment that has ceased does not need to be disclosed where the questionnaire does not expressly cover that type of condition. A subsequent deterioration or chronic manifestation occurring only after conclusion of the contract cannot found reticence retroactively.

Texto completo

Descripteurs

ASSURANCE SOCIALE; AM; VIOLATION DE L'OBLIGATION D'ANNONCER; ASSURANCE COMPLEMENTAIRE; ASSU

Normes

LCA.4

Résumé

Celui qui a souffert récemment mais ne souffre plus de sinusite, n'a pas à mentionner cette maladie dans un questionnaire qui ne fait pas référence à ce type d'affection. Si la sinusite s'installe de façon chronique après la signature du contrat d'assurance, il n'y a pas de réticence.

Palavras-chave

insurance disclosurereticencequestionnairepreexisting conditionsinusitissupplementary insurance

Extraído pela Omnilex

Questões jurídicas principais extraídas pela Omnilex

Questão jurídica principal

Whether prior sinusitis had to be disclosed in the insurance questionnaire and whether later chronic sinusitis constituted a reticence under Art. 4 LCA.

Decisão extraída

A recently past but no longer existing sinusitis did not have to be disclosed in a questionnaire that did not ask about that type of ailment; if the sinusitis became chronic only after contract conclusion, there was no reticence.

Fundamentação extraída

The duty to disclose under Art. 4 LCA extends only to facts covered by the insurer's questions. A past ailment that is no longer present is not disclosed if the questionnaire does not specifically address such affection, and a post-contract chronic development cannot retroactively establish concealment.

Sinusitis need not be disclosed absent relevant questionnaire questionGerado por IA