Insurance contract: Life insurance company has no right to delay payout

Life insurance must pay immediately in case of accidental death:

The Saarland Higher Regional Court (OLG) Saarbrücken decided (Ref. 5 U 286/05-26) by judgement of 09.11.2005 that the insurer is not entitled to delay the payout of a life insurance policy. Due to late payment, the insurer had to reimburse or assume the plaintiff’s costs as damages.

Accidental death:

In the case in question, the policyholder died in an accident on 23.07.2004 – the insurer had already been notified of the event at the end of July 2004. On 21.02.2005, the heirs then filed an action against the insurer for payment, after a certificate of inheritance and a declaration of loss for the policies had been submitted.

Maturity of benefits according to § 11 VVG:

This provision states in paragraph 1: “Cash benefits of the insurer are due upon completion of the surveys necessary to determine the insured event and the scope of the insurer’s benefits.” The OLG explained § 11 I VVG with the words “Necessary surveys are those which an averagely diligent insurer of the relevant class of insurance must undertake in order to examine and conclusively determine the insured event, its obligation to pay benefits and the scope of the benefit to be paid by it.”

In the opinion of the court, this period had long since expired – the insurer had not paid despite the due date and the request for payment/reminder. Therefore, he later had to bear the costs of the legal dispute – even the payment of the insurance benefit after the filing of the lawsuit did not change anything.

 

by Dr. Johannes Fiala

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About the author

Dr. Johannes Fiala Dr. Johannes Fiala
PhD, MBA, MM

Dr. Johannes Fiala has been working for more than 25 years as a lawyer and attorney with his own law firm in Munich. He is intensively involved in real estate, financial law, tax and insurance law. The numerous stages of his professional career enable him to provide his clients with comprehensive advice and to act as a lawyer in the event of disputes.
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