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Case Details

Case Details
National ID 313/07.0TBSJM.P1.S1
Estado-Membro Portugal
Common Name AA v. Companhia de Seguros... S.A. and Banco... S.A.
Decision type Outro
Decision date 29/03/2011
Tribunal Supremo Tribunal de Justiça
Assunto
Requerente
Requerido
Palavras-chave

Unfair Contract Terms Directive, Article 3, 3.

At issue is the exclusion of clauses in a life insurance for breach of duty of information, as required by Article 5 of the DL no 446/85, of 25 October 1985. Such clauses under “special conditions” are not allowed to establish the concept of “absolute and permanent disability” and thus to limit the object of the contract.
AA. and Banco… S.A. had a loan agreement. AA had a life insurance contract with Companhia de Seguros… S.A., involving the bank. AA argues that he did not receive a copy of any policy or any copy of the insurance contract. AA also argues that he received no explanation of any limitations to the insurance coverage, so that AA only knew about the limitation of “absolute and permanent disability due to illness”. AA claimed against Companhia de Seguros… S.A. and the Banco… S.A in order to get recognized that the life insurance contract was existent, valid and in vigour in the part not affected, as it was signed by claimant and defendants and to get recognized that the clause of coverage limitation in the contract is invalid due to breach of duty of communication and information, as the content of this contract clause was not properly informed by the insurer.
- The clause inserted under "Special Conditions" establishing the concept of "absolute and permanent disability" is to be considered excluded of the contract of life insurance due to breach of duty of information, as this clause stands limits to the “Particular Terms” of the same contract concerning the definition of the contract object, in the sense that to the insured person nor a policy or a copy of the contract were handed out, nor further information on the limitations of the coverage was given, so that the insured person only knew to be as "absolute and permanent disability by disease".
- The insured person only adheres to and becomes part of the contract if the contract clauses correspond with the information received.
- The part of the contract which was not affected is still valid and effective, so that it is according to the subsisting contract clauses in line with the legal regulation on unfair contract terms that the object of the insurance contract is to be determined taking in regard the concrete situation of occurrence of an accident.
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