Recent activities of the President of the Office of Competition and Consumer Protection in the area of life insurance resulted in 600 examined standard contracts, 13 checked entrepreneurs and several clauses addressed to the Court. Almost all examined undertakings applied prohibited clauses.

The offer of insurance companies gives all consumers the right to voluntarily insure their lives and health. These companies offer both individual and group insurances. In any case, the conditions of insurance and payment of compensation are set out in a contract – if we choose the individual insurance, a contract in writing is required. The rules of insurance policy and parties’ responsibilities are contained in insurance standard terms and conditions, as well as in the signed contract.

The latest report of UOKiK concerning control of agreements used by 13 insurance companies shows that the rights of consumers insuring their life are not always respected. UOKiK’s branch offices examined 600 standard contacts applied by the following life insurance companies: AXA Życie, CARDIF Polska, Aviva, COMPENSA, EUROPA, HDI-Gerling Życie, PZU Życie, ING, NORDEA Polska, WARTA, LINK4 Life, Sopockie TU na Życie ERGO HESTIA and PRAMERICA Życie TU i Reasekuracji. Apart from the life insurance contracts, the control of insurance policies covered also marriage, pension, accident and sickness insurance, as well as products securing children’s future – almost all of them included illegal, ambiguous and unclear provisions.

First of all, the Office questioned the provisions enabling the insurers to change the scope of services and their providers (e.g. healthcare facility in case of medical insurance) by themselves. As a result, the entrepreneur had the possibility to unilaterally decide on the conditions of insurance during the period of the policy validity. According to UOKiK, when selecting a specific offer, the consumer pays attention particularly to its scope. If the other party of the contract grants itself the right to change the agreement at any time of its duration, such behaviour violates the economic interests of the consumer who pays the insurance premiums and expects protection in line with the contract.

The Office found that almost all examined companies used ambiguous and unclear provisions, which enabled their free interpretation. The greatest objections were raised in respect to clauses which, if interpreted in favour of the insurer, may have deprived the consumer of the right to benefit payment. For example, one of the entrepreneurs reserved the right to refuse the payment, if the unfortunate event occurred as a result of an unspecified and unjustified failure to act in line with the medical advice. As a result, the consumer was unsure in what cases the company may refuse to pay the compensation or implement the benefits laid out in the contract. According to UOKiK, restriction of the insurer’s liability should be clear and precise to make the consumer certain in which cases the entrepreneur may refuse to pay compensation or implement the benefits set out in the contract.

The Office also considered as unlawful those practices which mislead especially elderly consumers within the length of the insurance protection period. The clause contested stated that after the consumers reach certain age the insurer excludes its responsibility against the consumers, despite the concluded contract and despite the fact that they still pay their insurance premiums. The liability of the consumer within the scope referred to in (...) stops regardless of the provisions of the insurance contract on the day of reaching by the consumer the age of 70. Lack of insurance protection within the period for which the insurance premium was paid constitutes, according to UOKiK, a gross violation of the economic consumer interests – analogically to the practice of limiting the amount of the paid compensation to consumers who have singed more than one life insurance policy. UOKiK’s control has shown the tendency that insurance companies pay compensations covered by only one contract despite the fact that the consumer paid insurance premiums and was protected by several life insurance policies. Pursuant to the law, in case of life insurance, the insurance company is obliged to pay to the aggrieved party the compensation envisaged in all concluded contracts.

Moreover, the Office questioned the provisions onerous for persons insuring their lives, inter alia, provisions obliging the consumer to supply all the information to the insurer via a registered letter, while the insurer is not imposed such an obligation. It is also unjustified to demand from the consumer submitting the original of the contract along with an application for benefit payment in the event of loss as providing the entrepreneur with the original of the contract, the consumers lose the document which is the basis to claim their rights in the future. Insurers also act unlawfully setting too short deadlines to report the information concerning the accident.

During the control the insurance companies voluntarily ceased some of the prohibited clauses. However, in order to avoid breaches of the law in the future, the Office has already filed four claims to the court – another six are under way – to recognise a total of 23 clauses as prohibited. Moreover, the President of UOKiK has already issued decisions regarding three life insurance companies: Compensa, HDI – Gerling Życie and Sopockie TU na Życie ERGO HESTIA. The fines imposed on the undertakings amounted to PLN 539,964.

At the same time, the Office reminds that the consumer who wants to use the services provided by an insurance company should always receive a contract and read it carefully. When selecting an insurance company, do not make your decision solely on the basis of the insurance premium, but it is advisable to analyze the full scope of insurance protection as well as the rights and obligations of the parties to the contract. If you fail to understand the provisions of the contract, ask the insurer to make them more precise. A consumer who intends to conclude a contract and has discovered there a prohibited clause, included in the Register of Prohibited Clauses should point it out to the enterpreneur. If the trader disagrees to change the contested clause, it is best to change the contractor. If an already concluded contract includes clauses from the Register, the contract is not binding for the consumer. If the entrepreneur fails to recognize the argument, the consumer should address the relevant Court to declare the provision as null and void.

Facing problems with an insurance company, the consumer should address the Insurance Ombudsman. The dispute may be settled by the Court of Arbitration at the Insurance Ombudsman.

Additional information:
Małgorzata Cieloch, Spokesperson for UOKiK
Department of International Relations and Communication
Pl. Powstańców Warszawy 1, 00-950 Warsaw, Poland
Tel. (+48 22) 827 28 92, 55 60 106, 55 60 430
faks (+48 22) 826 11 86
E-mail: [SCODE]bWFsZ29yemF0YS5jaWVsb2NoQHVva2lrLmdvdi5wbA==[ECODE]