When we take out life insurance and especially health insurance, we usually have the obligation to answer a questionnaire about our state of health. In fact, according to the General Directorate of Insurance and Pension Plans, all health insurance marketing companies, with the exception of one that only admits components of religious orders, establish the obligation to fill in this questionnaire.

Insurance Contract Law

Insurance Contract Law

This measure is more than logical, since it defines the risk that will be covered as reflected in the Insurance Contract Law in its article 10: “The policyholder has the duty, before the conclusion of the contract, to declare to the insurer, in accordance with the questionnaire that he submits, all the circumstances known to him that may influence the risk assessment ”to which he adds that“ He will be exempt from such duty if the insurer does not submit a questionnaire or when, even submitting it, it is circumstances that may influence the risk assessment ”.

For all this, the policyholder has the obligation to declare the illnesses that he suffers or has suffered, so that the insurer makes a correct assessment of the risk he will assume. Therefore, the questionnaires contain a detailed series of questions that must be completed and signed by the policyholder.

Reflect all information

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The insured must correctly answer all the information that must be shown in clear questions, which are not subject to interpretation. Generally we will have three types of questions:

  • Health habits: with questions about smoking or alcoholic beverages
  • Medical history: issues related to diseases you have suffered, chronic ailments, surgical interventions, medical leave …
  • Current status: Allergies, current medical treatments …

Contact your insurance company

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On all these, in the case of any doubt about them, it is important that you contact your insurance company and / or a medical service so that it can solve it. If the insured omits any relevant information, the company may leave some services without coverage or even challenge the contracted policy. For this, the insurer should demonstrate that the policyholder omitted that information at the time of signing the policy.

Before that, as indicated in the aforementioned article 10, the company may “terminate the contract by means of a declaration addressed to the policyholder within one month, based on the knowledge of the reservation or inaccuracy of the policyholder. The premiums relating to the period in progress at the time this declaration is made shall correspond to the insurer, unless there is fraud or serious fault on their part. ”

The entity may also, depending on the responses of the health questionnaire, request prior medical reports on a specific condition or request specific tests on it.

In short, the health questionnaire gives us access to our insurance and benefits its coverage, establishing the conditions for its application.