Policy disputes

What we do

A dispute may arise between the insurer and the insured regarding the damages to be paid and the amount thereof. The policy conditions specify which damages an insurer is required to pay. However, in certain cases, a dispute may arise concerning the interpretation of the policy conditions. Our insurance law practice group possesses the legal expertise and practical experience to provide support in such a conflict. This means that our lawyers and legal experts can offer assistance in negotiations with the insurer. If these negotiations are unsuccessful, an attempt can be made to enforce the payment of damages through the courts.

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.

Policy disputes within insurance law

A policy dispute is a conflict between insurer and insured regarding the content, interpretation, or application of the insurance agreement. Within our field of expertise, Insurance Law, policy disputes form a core component: they touch upon the question of what you have actually insured yourself against. Unlike a purely coverage dispute, which revolves around the question of whether a specific loss falls under coverage, a policy dispute often concerns the interpretation of the policy conditions themselves: what did the parties agree upon and how should a provision be understood? We assist both international corporations and the baker around the corner, with mixed teams of lawyers and in-house counsel who combine the technicalities of the policy with an eye for your commercial interests.

How are policy conditions explained?

The outcome of a policy dispute stands or falls with the interpretation of the policy conditions. In principle, the court applies the Haviltex standard: decisive is not only the linguistic meaning of the text, but also what the parties could reasonably infer from each other's statements and conduct. However, in the case of insurance policies that have not been negotiated and are intended for a large group of policyholders, the court interprets the conditions more objectively. In such cases, the wording, read in the light of the entire policy and any explanatory notes, is particularly decisive. Consumers enjoy important protection: if a clause in the policy conditions is unclear or open to multiple interpretations, the interpretation most favorable to the consumer prevails pursuant to Article 6:238 paragraph 2 of the Dutch Civil Code (the so-called contra proferentem principle). In this way, insurers bear the risk of conditions formulated unclearly by themselves.

Common types of policy disputes

In practice, our lawyers and legal experts see policy disputes recurring in various forms. Below are the topics that occur most frequently, ranging from private policies to complex business programs.

Explanation of exclusions and inherent defect

Many disputes revolve around exclusion clauses and concepts such as “external damage,” “inherent defect,” or “insufficient precautionary measures.” The question then is whether the cause of the damage falls within or outside the coverage. In principle, the burden of proof regarding coverage lies with the insured; if the insurer invokes an exclusion, that insurer must substantiate it.

Duty to disclose and concealment

When taking out insurance, a duty of disclosure applies (Article 7:928 of the Dutch Civil Code). If the insurer subsequently claims that you withheld relevant information, this may have consequences for the payout. We assess whether the insurer's claim is justified and what sanction is appropriate.

Reporting damage and duty to mitigate

The insured must report damage in a timely manner and cooperate with the investigation (Article 7:941 of the Dutch Civil Code). Late reporting or incomplete information may be used by the insurer to limit the payout. We assess whether the insurer has actually suffered harm to a reasonable interest.

Statute of limitations on your claim against the insurer

A policy dispute is subject to a strict time limit. Pursuant to Article 7:942 of the Dutch Civil Code, the legal claim against the insurer for payment lapses after three years, calculated from the day following the day on which the insured became aware of the claim's enforceability. The limitation period is interrupted by a written notification claiming payment; if the insurer unequivocally rejects the claim, a new three-year period begins to run. For liability insurance, a different arrangement applies, whereby negotiations interrupt the limitation period. Because a missed deadline is fatal to your claim, we closely monitor these dates and interrupt them in a timely manner where necessary.

Dispute resolution: from negotiation to court

Not every policy dispute needs to end up in court. We choose the route that best suits your interests. It often begins with a substantiated demand letter and negotiations with the insurer or their claims handler. If you are unable to reach an agreement together, various avenues remain open. Private individuals and small business owners can usually turn to the Financial Services Complaints Institute (Kifid), which rules on disputes with insurers and intermediaries in an accessible and cost-effective manner. For business and larger disputes, recourse to the civil courts or arbitration is the more obvious choice. Our lawyers can represent clients in all these proceedings; our in-house counsel provide support with advice, negotiations, and case file preparation. Read more about coverage disputes or the complaint procedure at Kifid.

What MKB Juristen does for you in the event of a policy dispute

At MKB Juristen, lawyers and in-house counsel work together in mixed teams. This combination makes the difference: the litigious authority and legal clout of the lawyer, coupled with the practical, solution-oriented approach of the in-house counsel. We analyze your policy and the insurer's rejection, assess the standard of interpretation and your evidentiary position, and advise on the chances of success. Subsequently, we negotiate, interrupt the statute of limitations, and litigate where necessary. Whether you are an international group with an extensive insurance portfolio or an entrepreneur with a single business policy, we represent your interests. Contact us to discuss your policy dispute without obligation.