New law amending the Insurance Act as regards exclusion grounds related to a suicide attempt in complementary health insurance

The law of 21 April 2024 amending the law of 4 April 2014 on insurance as regards the grounds for exclusion in non-compulsory health insurance related to attempted suicide was published this Thu. 16 May in the Official Gazette.
 
The bill for this law was submitted to the Chamber of Representatives slightly over 2 years ago, in March 2022. As stated in the explanatory memorandum accompanying the proposal, costs resulting from a suicide attempt are almost always explicitly excluded in non-compulsory complementary hospitalisation insurance, or else fall under the more general exclusion of ‘intentional acts’. The refusal to reimburse these costs contributes to the stigmatisation of such mental health problems and further exacerbates the already difficult (financial) situation of those who have attempted suicide. It therefore aims to provide that damages resulting from a suicide attempt by the policyholder may not be excluded in a health insurance contract. In order to prevent insurance companies from refusing a policyholder or charging an additional premium due to prior knowledge of a suicide attempt, a prohibition is also introduced against making attempted suicide an exclusion ground in complementary health insurance. Following a set of minor amendments, the bill was eventually passed in April this year.
 
Aside from the provisions cited above, the amending law also affirms, with reference to Article 58 of the Insurance Act (which provides that the policyholder has an obligation to declare diligently, at the conclusion of the contract, all known circumstances that must reasonably be considered a component of the risk assessment by the insurer), that a suicide attempt is to be notified to the insurer when concluding a health insurance policy. However, the insurance company is prohibited from taking the attempt into account when determining the individual’s current state of health following expiry of maximum a one-year term after the attempt.
 
The new provisions are set to enter into force on the first day of the sixth month following their publication in the Official Gazette and will apply to both new and previously concluded health insurance contracts from that date onward. Insurers will therefore need to revise their policies by this deadline if the terms and conditions conflict with the new legislation.
 
The law is available for consultation at http://www.ejustice.just.fgov.be/cgi/article.pl?language=nl&sum_date=2024-05-16&lg_txt=n&numac_search=2024004452 (in Dutch) or http://www.ejustice.just.fgov.be/cgi/article.pl?language=fr&sum_date=2024-05-16&lg_txt=f&numac_search=2024004452 (in French).
 
Questions? Contact our Insurance expert Sandra Lodewijckx.