Insurance agreement

What we do

The insurance contract is the agreement whereby the insured pays a periodic premium to the insurer, and the insurer undertakes to make a payment in the event that the insured circumstance occurs. At the time of concluding an insurance contract, it must be uncertain whether the insured circumstance (the insured event) will actually occur in the future.

We guide various organizations prior to concluding an insurance agreement and advise on the legal implications. This includes issues regarding the primary coverage description and guarantee clauses.

We have the experience and expertise to assume diverse roles, from advisory services to dispute resolution. We have an experienced team of lawyers and legal experts in insurance law. Contact us to discuss the possibilities.

The insurance contract within insurance law

The insurance contract is legally enshrined in Title 17 of Book 7 of the Dutch Civil Code. Article 7:925 of the Civil Code defines insurance as the agreement whereby the insurer undertakes, in exchange for the payment of a premium, to make one or more payments to the policyholder, while it is uncertain for the parties at the time of conclusion whether, when, or to what amount any payment must be made. This requirement of uncertainty is the legal heart of every insurance policy and partly determines whether an agreement qualifies as an insurance contract at all.

This page examines the insurance agreement within the broader framework of Insurance Law: its formation, the interpretation of the policy, mutual obligations, and disputes that may arise therefrom. Whether you are an international group negotiating an extensive insurance program or the baker on the corner seeking certainty regarding your business insurance, our mixed teams of lawyers and in-house counsel will help you ensure the agreement is legally watertight.

Indemnity insurance, sum insurance and personal insurance

The law distinguishes between two main forms of insurance. In the case of indemnity insurance (Article 7:944 of the Dutch Civil Code), the payout serves to compensate for concrete, actual damage suffered; the principle of indemnity prohibits the insured from being placed in a clearly more advantageous position as a result of the payout. In the case of sum insurance (Article 7:964 of the Dutch Civil Code), the insurer pays out a pre-agreed amount, regardless of the actual damage, as is the case with many life insurance policies. Additionally, Article 7:925 paragraph 2 of the Dutch Civil Code provides for personal insurance, which concerns the life or health of a human being.

The type of insurance determines which statutory rules apply and how the payout is calculated. For both business and consumer whether the chosen structure aligns with your actual risks and interests.

The pre-contractual duty of disclosure

Before the agreement is concluded, the policyholder has a duty of disclosure. Pursuant to Article 7:928 of the Dutch Civil Code, he must disclose to the insurer all facts that he knows or ought to know and of which he knows or ought to understand that they are relevant to the insurer's decision. For consumers, it applies that they may, in principle, rely on the questions expressly asked by the insurer.

Violation of this duty can have far-reaching consequences. Article 7:929 of the Dutch Civil Code gives the insurer the opportunity to point out the non-compliance within two months of discovery, and Article 7:930 of the Dutch Civil Code regulates the extent to which entitlement to benefits still exists. In the event of intent to deceive, the entitlement to benefits may lapse entirely. The burden of proof regarding concealment and intent rests with the insurer. An unfounded accusation of breach of the duty of disclosure is a common reason why benefits are refused; we critically assess such accusations and present a defense against them.

Premium payment, policy and obligations during the term

During the term of the insurance agreement, mutual obligations apply. The policyholder's core obligation is the payment of premiums. Article 7:934 of the Dutch Civil Code stipulates that failure to pay a subsequent premium may only lead to termination or suspension of coverage after the insurer has, after the due date and stating the consequences, unsuccessfully demanded payment within a period of fourteen days. The insurer, in turn, is obliged to issue a policy (Article 7:932 of the Dutch Civil Code).

If the insured event occurs, the policyholder or the person entitled to payment must report this as soon as reasonably possible pursuant to Article 7:941 of the Dutch Civil Code and provide the insurer with the necessary information. A limitation period of three years applies to a claim for payment pursuant to Article 7:942 of the Dutch Civil Code. We monitor these time limits and obligations so that you do not forfeit your right to payment due to a formality.

Explanation of the policy and coverage disputes

The content of the insurance agreement is largely determined by the policy and the policy conditions. How concepts such as the primary coverage description, exclusions, and guarantee clauses should be interpreted is pre-eminently the area where disputes arise. As a rule, the Supreme Court applies an objective interpretation in this regard: for consumer policies concluded without negotiation, the wording, read in the light of the entire text and any explanatory notes, is decisive.

When the insurer refuses coverage, a coverage dispute. Our lawyers and legal experts analyze the policy, the facts, and the case law, and conduct negotiations with the insurer or your representative on your behalf. If we are unable to reach a mutual agreement, we will assist you in proceedings before the court or, for consumers, in the complaint procedure at Kifid.

What MKB Juristen does for you

MKB Juristen works with mixed teams of lawyers and in-house counsel. This combination means that we not only litigate, but also provide practical and commercial input during the drafting and execution of your insurance agreement. We review draft policies and general terms and conditions before you sign, advise on the duty of disclosure and the correct completion of the application form, and take action as soon as a dispute threatens regarding coverage, premiums, or payouts.

Our clients range from international corporations with a global insurance program to independent entrepreneurs and the baker around the corner who simply want to know where they stand. The same approach applies to all these clients: clear language, sharp legal analysis, and a solution tailored to your situation. Feel free to contact us to discuss your insurance agreement without obligation.