Higher Regional Court Dusseldorf, 10 March 2017: declaration of risk
An insured took out a health insurance policy through his broker, who only reported certain medical information to the insurer, omitting, in particular, information about the insured’s high blood pressure and confirmed heart failure in order to obtain better cover for its client. When a claim was made, the insurer discovered the false declaration, disputed the validity of the policy and refused to cover the insured. The insured then sued the insurer and the broker on the grounds that he had provided all the required information in good faith to the broker, who then deliberately failed to provide it to the insurer voluntarily. The insurer, for its part, denied the validity of the policy because of this false declaration.
The judges agreed with the insurer and held that the incorrect answers to the questionnaire entitled it to dispute the validity of the policy. In addition, they found that since the insured had truthfully informed the broker of his state of health and the broker had added the false statements in bad faith, it would be held solely liable for this false declaration.
Therefore, the court held that, although the insured had requested a low premium from his broker, it was not the broker’s responsibility to withhold certain medical information provided by the insured. The court found that fraudulent intent at the time of the declaration had been proved and, moreover, stressed that the broker represents the insured and must therefore be seen to be a trustworthy person in performing its duty to negotiate the most advantageous policy.