‘I signed up hiding my illness’... Law says, “I have to pay insurance premiums”

The court ruled that if the insurance agent interfered with the notification of medical history at the time of signing the contract, the contract cannot be terminated for this reason.

According to the legal community on the 20th, the Seoul Central District Court ruled in favor of the plaintiff in the insurance claim lawsuit filed by Mr. A, a man in his 50s, against the insurance company on January 21st.

Mr. A signed an insurance contract through insurance agent B in 2023.

Mr. A, who later received hospital treatment for myocardial infarction, filed a claim for related insurance money.

But the insurance company refused to pay.

The reason was that at the time of signing the insurance contract, Mr. A violated the 'duty to inform before signing a contract' by failing to disclose despite the fact that he had suffered from high blood pressure and hyperlipidemia in the past.

Mr. A was notified of the termination of the contract.

However, Mr. A filed a lawsuit claiming that he informed Mr. B, who was in charge, of his medical history.

However, at the time, Mr. B claimed that he only responded by asking him to check 'no' when asked about his medical history.

At the same time, he emphasized that the company's termination of the contract was invalid.

The court ruled in Mr. A’s favor.

The court pointed out, “It is acknowledged that the plaintiff did not disclose that he had been diagnosed and prescribed medication at a hospital in the past,” but added, “However, this was because the insurance agent actively interfered with the notification.”

He continued, "If it had not been for the planner's actions, the plaintiff would not have provided inadequate notice," and the insurance company judged that it had an obligation to pay a total of 28 million won, including diagnostic and surgical fees, to the plaintiff.

Attorney Shin Seong-min of Daeryun Law Firm, who represented Mr. A, said, “Insurance planners have an obligation to explain the important contents of the contract in specific and detailed terms,” and added, “If the contract is concluded without complying with this, the insurance contract cannot be terminated.”

He added, "In this case, even though Mr. A informed us that he had a medical condition at the time of signing the contract, he was induced to give a false answer, so it can be seen that he failed to fulfill his obligation to explain."
 

Reporter Jeong Eui-jin (jej88@ikbc.co.kr)

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'I signed up while hiding my illness'... Law, "Insurance benefits must be paid" (Shortcut)