In what cases does a life insurance policy not pay out?

Question

José Manuel Alburquerque · Accepted Answer

Only in a few, narrowly defined cases. The law says that the insurer is released only if the death is due to a cause expressly excluded in the policy. Added to this are some cases laid down by law, such as suicide in the first year if the policy does not cover it sooner, wilful or grossly negligent concealment of an illness that was asked about or non-payment of the premiums. Once a year has passed since signing, the insurer can no longer claim that something was concealed from it, unless there was wilful misconduct. The grounds laid down by law Suicide during the first year after signing, unless the policy covers it sooner. Concealed or false health information in the questionnaire. If there was wilful misconduct or gross negligence, it does not pay. If there was neither, it pays proportionately less. And after the first year, it can only rely on this if there was wilful misconduct. Unpaid premiums. If the first premium was not paid through the fault of the person who took out the policy, it does not pay. If a later one is missed, cover is suspended one month after the due date. In life insurance with a savings element, after the period set by the policy, which cannot be longer than two years, non-payment reduces the policy instead of suspending it. Death deliberately caused by the beneficiary. The beneficiary loses their right, but the insurer is not released, because the money goes into the assets of the person who took out the policy. Incorrectly stated age. It can only cancel the policy if the true age was above the maximum for taking it out. Otherwise, it pays in proportion to the premium collected. Policy exclusions Only causes that the policy expressly excludes count, such as war, certain dangerous sports or driving under the influence of alcohol. Exclusions that cut back what you could expect from the policy must be highlighted and signed separately. And it is the insurer that has to prove that they apply. A maximum age for cover set by the policy, for example 65, is valid without a special signature if it is clear. A special case If the death is due to an extraordinary flood, an earthquake, a terrorist attack or another extraordinary risk, even if the policy excludes it, the sum insured is paid by the “Consorcio de Compensación de Seguros”, Spain's state insurance compensation fund, provided that the life insurance was in force.