Insurance Lawyer in Portugal, Porto
Legal support for policyholders in claims and disputes with insurers
In Insurance Law, the firm always acts for the policyholder: in denied claims, road accident claims and disputes over life and disability insurance.
Denied Claim
Denial or undervaluation of a claim by the insurer
An insurer may only deny or reduce a claim on concrete grounds, whether an exclusion in the policy, an omission in the initial risk declaration or failure to report the claim on time.
Car Accident
Car accident lawyer: road accidents and the deadline to claim compensation
After a car accident or other road accident, the right to compensation arises from civil liability, not from the insurance contract, and the deadlines are not the same.
Confusing the two deadlines is a common mistake, and it can cost the right to compensation.
The deadline to report the claim to the insurer
Before any discussion about the amount, there is a short deadline to report the claim to the insurer, set by the insurance contract law and, as a rule, repeated in the policy.
Reporting late does not necessarily extinguish the right, but it gives the insurer grounds to reduce the payment to the extent of the harm the delay caused it. It is one of the most invoked grounds for denial, and the dispute is about what the delay prevented it from establishing.
Life Insurance
Life and disability insurance
In life and disability insurance, the most common disputes arise from:
Pre-existing condition
Exclusions for conditions that pre-date the contract.
Questionnaire answers
Health questionnaire answers that the insurer considers incomplete.
Degree of disability
Disagreements over the degree of disability assigned.
Each of these grounds has to be analysed in light of what was declared at the start of the contract and how the insurer handled underwriting.
Policy
Reviewing the policy before deciding how to act
Before challenging an insurer's decision, the policy has to be read carefully: the cover taken out, the exclusions, the deductibles and the reporting deadlines. That is where you see whether the refusal has a basis.
Out-of-Court
Out-of-court routes in insurance disputes: complaint to the insurer, the ASF and CIMPAS
Before going to court, there are two out-of-court routes.
ASF
The Insurance and Pension Funds Supervisory Authority (ASF) is the sector regulator and receives complaints, but has no power to set compensation.
CIMPAS
CIMPAS, the Insurance Information, Mediation, Ombudsman and Arbitration Centre, authorised by the Ministry of Justice, offers mediation and arbitration, and the arbitral decision has the force of a court judgment.
Neither route is mandatory before going to court, but going through them can resolve the dispute without the cost and time of a lawsuit.
Court
Court route: when to go to court
Going to court makes sense when the amount at stake is high, when the out-of-court routes do not lead to agreement, or when the limitation period is approaching.
Speak to an Insurance Lawyer in Porto
Describe the claim or the insurer's refusal. We will tell you whether there are grounds to claim and which route to follow.