THE ESSENTIALS
Before you start
- The increased-risk framework in Articles 93 and 94 does not apply to life insurance.
- For the supplementary covers identified in Article 190, the increase arising from health is an essential distinction.
- This rule neither decides whether there is a covered claim nor corrects inaccurate initial disclosure.
The exception specific to life insurance
Article 190 of the Portuguese Insurance Contract Act excludes life insurance from the increased-risk framework in Articles 93 and 94. The general sequence of notifying increased risk, proposing changes and consequences for a claim under those articles should therefore not automatically be imported into life insurance.
Sofia’s question concerns health changing within a contract already entered into. That rule differs from asking whether a new policy will be accepted or whether an illness meets the event defined in the policy. Clara does not conclude that a capital benefit is due simply because there is a diagnosis.
Read the provision for supplementary covers too
The same article excludes that framework from accident and disability due to accident or illness covers supplementary to life insurance where the increased risk arises from the insured person’s state of health. The health-related origin matters in this part of the provision. Do not turn it into a general exemption for any change of activity, occupation or other circumstance.
Create one line for each guarantee: main life cover, supplementary accident and supplementary disability, as the contract provides. Alongside, note the actual change and the question received. This avoids answering about one guarantee using a rule that was discussing another. A policy containing several covers still requires this separation.
After inception differs from known beforehand
Article 24 concerns initial disclosure of known, relevant circumstances before entering into the contract. The Article 190 exception does not rewrite answers given at that stage or turn an already-known fact into a new one. Nor does it authorise disclosing information protected by law: uncertainty about what may be requested should be clarified through the proper process.
A later diagnosis alone does not let Sofia or Clara decide when a condition began or what was known in the proposal. If the insurer invokes inaccurate initial disclosure, ask it to identify the question, facts and basis. Keep the proposal and actual chronology; a dispute of this kind may need specialist examination of the case.
Legal protection does not replace the insured-event definition
If the situation may correspond to a contracted cover, check the claims-reporting procedure. Article 100 provides for reporting the insured event and relevant information about it. Excluding the increased-risk framework does not remove that task or let anyone ignore definitions, exclusions and conditions concerning the event invoked.
Also distinguish a health question from a pricing question or a request to increase the sum insured. Article 190 does not promise a fixed premium throughout the contract or demonstrate acceptance of a new proposal. Ask what is changing and the reason stated, without cancelling existing protection to test an alternative.
Prepare a documented question without public clinical disclosure
Sofia privately gathers the reference and inception date, guarantees in force and the communication she wants clarified. Clara helps formulate the question: does it concern health changing during the contract, initial information or reporting an event? The list organises the conversation; it neither classifies the illness clinically nor decides a benefit.
Use policy support for an existing contract. To compare future protection, select Vida under Request a quote on the RMACHADO website, starting with needs without submitting diagnoses in the initial form. Where health data is necessary in the proper process, ask for the appropriate channel and legitimate recipient; do not place it in comments or public messages.
KEEP THESE QUESTIONS
Your checklist for the next conversation
- Identify the contract in force and separate its guarantees.
- Distinguish later health changes from initial information and a claim.
- Ask for the specific basis of a change or decision received.
- Keep the chronology and use the proper channel for necessary health information.
FROM THE ARTICLE TO YOUR SITUATION
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Sources and transparency
Content updated on .
Consultation dates are stated in individual references when available.
Numerical examples are fictional and explain concepts. Editorial interpretations are identified in the text.
Information from RMACHADO GROUP. This is not an insurance offer or individual advice. Covers, acceptance, exclusions, sums insured and costs depend on the policy. The intermediary does not underwrite the risks.