When taking out health insurance, some insurers ask you to fill in a form about your state of health, including medical history, family background and lifestyle habits. But are you obliged to answer? In this article, we answer this question.
Do I have to answer the questionnaire to get health insurance?
According to the Legal Framework for Insurance Contracts (RJCS), enshrined in Decree-Law no. 72/2008, those interested in taking out health insurance are obliged to answer a medical questionnaire.
Legal Framework for Insurance Contracts
Article 24.º
Initial Declaration of Risk
1 – The policyholder or the insured person is obliged, prior to the conclusion of the contract, to accurately declare all the circumstances that they know and should reasonably consider to be significant for the insurer’s assessment of the risk.
The questionnaire is part of the initial risk declaration and is compulsory. This is a decisive element in the conclusion of the health insurance contract, as it allows the insurer to make a correct assessment of the risk.
By filling in the form, you avoid situations that could cause doubts or misinterpretations, so the questions asked should be as objective and precise as possible. They can include, for example, questions about periods of hospitalization, associated surgeries or relevant pathologies.
According to the Decree-Law, the insured person is obliged to declare all relevant illnesses they are aware of truthfully and accurately. In fact, the law penalizes anyone who willfully or knowingly omits important medical information and, if it is proven that the insured has not been completely honest, the insurer has the right to refuse insurance.
Legal Framework for Insurance Contracts
Article 24.º
4 – The insurer, before concluding the contract, must explain to the policyholder or the insured person the duty referred to in paragraph 1, as well as the rules governing non-compliance, under penalty of incurring civil liability, under the general terms.
These are some of the questions you might find in a questionnaire of this nature:
- Have you ever had your health insurance refused, postponed or accepted but made worse?
- Are you or have you ever been a smoker?
- Do you suffer or have you suffered from any disease, disorder or problem of the cardiovascular system, respiratory system or other?
This way, the insurer has all the information it needs to advise you on a health insurance policy that suits you, your household and your needs.
Do the answers to the questionnaire influence the price of health insurance?
The answer to this question is yes. The more health risks there are, the more expensive the health insurance will be.
After analyzing the answers to the form, and if a health problem is detected that already exists or is very likely to occur, the insurer may accept the insurance by increasing the premium. Let’s take an example.
A young, healthy couple who play sport are less likely to need medical care than an older couple with physical limitations and health problems typical of their age. Some insurers even require that, from a certain age, applicants for health insurance also present a medical examination form.
If you’re still wary of the advantages of having health insurance, here are 5 reasons to invest in one.
Do you still have doubts about the compulsory nature of life insurance questionnaires? Need more information or want to do a simulation? Talk to us! We’re insurance experts and we’re happy to answer your questions.
