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Nota legal

Estoppel in claims handling

27/01/2021

This Legal Briefing analyses the issues relating to estoppel that may arise for insurance companies during the claims handling process.

The whole raison d’être of an insurance policy revolves around the indemnity, whether that be in the form of monetary compensation following a loss, or assistance following a mishap or a situation where a service is required -repair, travel assistance, health care, etc.- that the insurer will provide. Once the insured party has shifted a certain risk to the insurer under the parameters set out in the insurance contract, when a loss covered under the policy occurs, the insured party deserves a positive response from the insurer.

With losses, however, things are never black and white. Fraud attempts notwithstanding, many losses require an investigation, not only of their causes, but also of the extent of their consequences. This is in addition to the fact that sometimes different insurance policies might cover the same loss, there is a lack of information, or the damage is continuous and cannot be properly assessed without a certain margin of time.

The entire content of the Legal Briefing can be found in the PDF.