Auto Insurance

Accident insurance: Do not conceal any previous illnesses

According to a judgment of the Higher Regional Court (OLG) Cologne, the fraudulent concealment of previous illnesses can also cost insurance coverage in private accident insurance (Az .: 20 U 224/12). This is indicated in the “monthly for German law” (issue 17, 2013).

In the specific case it was about an insured person who sued against his private accident insurance. When reporting an accident, he did not state that he suffered from back problems. After the accident, the man had, among other things, a spinal disc injury and asserted a permanent reduction in his earning capacity against his insurance company.

When the insurance company found out that the man had previously suffered a back problem, they refused to pay. Rightly, judged the Cologne Higher Regional Court, because the plaintiff would have been obliged to report his back pain at an early stage, as it would have been important for the assessment of the insured event. That he had not done this can only be assessed as fraudulent, therefore the insurance does not have to pay.

This is also independent of the fact that the plaintiff was not explicitly asked about previous illnesses when reporting and that Affected parties were not expressly advised of their obligation to provide information and the consequences of breaching this obligation. The judges were convinced that proper instruction would not have prevented the malicious deception.

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