It is a tale as old as time, take a person duly paying all insurance fees within the applicable payment deadlines, then a sudden storm tears off a part of the insured roof – all of a sudden you may find yourself seemingly in midst of a fight against windmills, where the insurance company is referencing fine print provisions of the insurance policy in order to decline compensation claims, unless you know your rights.
Insurance Claim Report Process
The reporting of claim process usually starts with an online request addressed to the insurance company. Based on this request the insurance company sends a damage claim expert to an onsite inspection for assessment of the damage, closing this initial phase with a damage claim report. Following this report the insurance company will either ideally grant the compensation for the insurance claim, or will decline the compensation and the windmills start turning…
The Defintion of a Consumer
Based on Hungarian law many insurance types are obligatory (such as car driver’s insurance or attorney liability insurance), however many are merely recommended although undisputedly useful. Generally, when a natural person pays monetary consideration for services rendered ourside of the natural person’s own profession or otherwise business activity then such person is considered a consumer. Often times this is the case with insurance related services as well.
The purpose of consumer related legislation is to protect those who are either obliged or willingly choose to use certain services. This is where the fine print of the insurance policies come into play.
Unfair General Contractual Terms
The relevant legal provisions as stipulated by the Hungarian Civil Code state that any generel contractual term or condition which is enforced to the detriment of the contracting party opposed to the party applying the said contractrual terms unilaterally and unreasonably, breaching the requisite norms of goodwill and good faith are considered to be unfair.
Contrary to the above, contractual terms which are constituted based on legal provisions or in line with prevailing laws are not to be considered as unjust.
Special Consumer related Legal Provisions pertinent to Insurance Policies
In case of any dispute arising from insurance policies related to consumers and general contractual terms and conditions, it is the obligation of the contracting party which is applying such terms (that is usually the insurance company)to prove that these conditions have been discussed specifically with the client. This goes also for any terms which are not clear and thereby could give grounds to misunderstanding. In case of consumer related agreements, unjust contractual conditions are null and void and may be claimed for the benefit of the consumer.
In case of insurance policies, apart from the above, the policy may exclusively derive for the benefit of the insured or the beneficiary when it comes to the following:
- reporting of changes applicable to the insurance policy;
- insurance claim report;
- suspension of compensation by the insurance company; further
- compensaton claim.
Please note that the applicable law does stupilate several other cases, however the above is a collection of the most common claims in general practice.
Summary
Based on the above, the prudent way to proceed is to familiarize yourself even with the fineprint of the insurance policy and to have a clear understanding as to which factors could possibly affect the potential compensation claim towards the insurance company.
Finally, as a consumer it is crucial to know your rights and have an insurance expert explain what the terms and conditions of the insurance policy mean in practice based on the given situation for which you plan to conclude a contract in order to avoid fights against windmills.
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