New Court Success. Claim a Life Insurance Policy. We Recover 150,000€ from a Client’s Life Insurance.

Litigation in Spain has extensive and successful experience in assisting our clients with claims for life insurance policies. In today’s article, we would like to share with our readers a new court success from our firm. This involves a claim filed against an insurance company that refused to pay the 150,000€ compensation outlined in the policy, which the widow of the deceased was entitled to. If you would like to read the full judgment, 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, such as previous illnesses, pending medical tests, medications being taken, smoking habits, and so on.

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 when the insurance was taken out. If the deceased omitted any illness or pathology that could be related to their 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 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 this voluntarily and without presenting any health issues. The doctor who attended him also ordered a chest X-ray. The results of both tests were normal. 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 simply given a generic recommendation (applicable to almost everyone): to exercise occasionally and maintain 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. They also claimed 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 favor of the insurer. However, we appealed the decision to the High Court of Alicante, confident 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) had been issued after the death. In other words, the tests had not been properly prescribed to the patient before his death. Therefore, there was no concealment whatsoever. As requested by our firm, the Provincial Court of Alicante 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 Litigation in Spain, we are experts in legal claims. We will study the viability of your case and offer you expert legal advice on how to claim a life insurance payout.