Have you suddenly received a message from your insurer that your coverage has been suspended? This can have major consequences: damage is no longer compensated, your insurance is temporarily "on hold," and you face financial risk. However, the use of suspension is not without risks for the insurer. If the suspension was unjustified, the insurer can be held liable for the damage caused as a result.
Pay close attention when you receive such a notification. In many cases, suspension is not simply permitted, and there are rules that the insurer must follow. This means you can contest an unjustified suspension and may even claim compensation. But an insurer is by no means always allowed to suspend. In many cases, this is unlawful, and you can object.
At Arslan Advocaten, we help clients with unjustly suspended or terminated insurance policies. We assess whether the measure is justified, file objections, and recover costs from the insurer where possible — so that our assistance can be free of charge for you.
What does suspension of coverage mean?
Suspension means that your insurance still exists, but the insurer temporarily provides no coverage. Any damage during this period will not be paid out. This is often applied when the insurer:- doubts the accuracy of your claim,
- suspects fraud or deception,
- believes you have not provided information, or
- you have not yet paid overdue premiums.
When is it advisable to use suspension?
Suspension of coverage is not a step that should be taken lightly. It can be a powerful tool for the insurer to obtain information or enforce payment. However, it is recommended to use this measure only when there are genuinely well-founded reasons, such as a serious suspicion of fraud or when someone systematically refuses to comply with the policy conditions. Pay attention to the following points:- Legal basis: Always carefully check whether there is a legal or contractual basis for suspension — and whether it fits the specific situation.
- Balancing of interests: Ask yourself whether temporary suspension is truly justified. For example: Is the requested information of decisive importance? Or is there a serious risk for the insurer?
- Proportionality and reasonableness: Use suspension proportionally. The measure should not be more severe than necessary to achieve your goal.
When may an insurer suspend coverage?
An insurer may only suspend coverage if there is a clear legal basis for doing so. This is usually stated in the policy conditions and in the law (Article 6:262 of the Dutch Civil Code). Furthermore, the Dutch Civil Code (Article 6:52, paragraph 1) provides that a debtor — in this case the insurer — may suspend the fulfilment of their obligation (paying out the claim) as long as they have an enforceable claim against the other party (the insured). However, this authority has important legal and practical limitations. The law specifies three situations in which suspension is not possible:- If the fulfilment of the insured's obligation is prevented by creditor default.
- If it is permanently impossible to fulfil the insured's obligation.
- If attachment is not permitted on the insured's claim.
- Suspension is only permitted when the insurer has a legitimate interest.
- The measure must be temporary and proportional.
- The insurer must inform you in advance and explain why the coverage is being suspended.
- You must be given the opportunity to respond or to provide the requested information after all.
In what ways can suspension be contractually limited, excluded, or extended?
In practice, the right to suspension is often further defined or restricted in the policy conditions. This is done, for example, through additional agreements on when and how suspension may take place. Below are some common ways in which parties can modify the right of suspension:- Mandatory prior notification: Many policies state that the insurer must always first announce in writing that suspension will follow. Only after you have been given a reasonable period to respond (for example, 5 working days) may the insurer actually suspend coverage.
- Limitation to specific obligations: Sometimes suspension applies only to specific provisions within the agreement. For example, if the right to suspension is excluded for premium payments but not for providing information, the entire coverage cannot simply be suspended.
- Maximum duration of suspension: It is common for the policy to state that suspension may not last longer than a fixed period, such as five working days. This prevents you from being at risk for a long, indefinite period without coverage.
- Complete exclusion or extension: In special cases, the right to suspension may be completely excluded or extended to situations that would not normally fall under the law.
Deviating from the legal rules: is that allowed in your contract?
Perhaps you are wondering: may an insurer or you yourself deviate from the legal rules regarding suspension? The answer is: yes, that is possible. The main rule from the law remains leading, but in practice, deviations are regularly made through the policy conditions or the contract. For example, it is often agreed in the contract that suspension is only allowed after a written warning — with a clear deadline for action. Only after that deadline may the insurer actually proceed with suspension. Furthermore, the right of suspension can be limited or even excluded in the contract for specific aspects. For example, you can agree that suspension never applies to the payment obligation, so that the insurer cannot simply pause your coverage in the event of payment disputes. Finally, the duration of suspension can also be contractually limited, for example to a maximum of a few working days. This prevents a temporary measure from continuing indefinitely.Must there be a connection between your claim and the obligation?
Yes, there must always be sufficient connection between the obligation you are suspending and the claim in question. In legal jargon, this is called "connection" or "connexity." You can therefore only suspend if your counter-performance is directly linked to what you demand from the other party. An example: Do you have a dispute with your insurer about a specific damage payment? Then you may only suspend your premium payment if that premium is specifically connected to the damage in dispute. It is not permitted to simply stop payment of all invoices because of a problem with one particular part of the insurance. In short: without that connection, suspension is not permitted — the law requires a direct link between the mutual obligations.What should you consider before deciding on suspension?
Before you as an insurer proceed with suspension of coverage, care is required. A wrong decision can lead to liability for damage to the customer. Prevent complaints — and possibly proceedings — by observing the following points:- Always check the policy conditions and the legal rules. Sometimes the contractual agreements deviate from what is stipulated in the law. Align your decision accordingly.
- Make a clear link between the problem and the suspension of coverage. Only when there is a direct connection may you apply this measure.
- Weigh reasonableness and proportionality. Is suspension necessary given the situation, or are there less drastic alternatives?
- Document the reason for suspension well and explain it clearly to the customer. Only then do you comply with the information obligation.
- Always set an end date or reassessment moment. Suspension may never be for an indefinite period.
- Give the customer sufficient opportunity to respond or submit missing information, so that you ensure the right to be heard.
Common reasons for unjustified suspension
- The insurer requests a disproportionate amount of information or evidence.
- Suspension after an unfounded suspicion of fraud.
- No hearing applied.
- No clear end date for the suspension.
- Violation of the information obligation towards the customer.
What can you do in case of suspension of coverage?
1. Request the written justification
The insurer must explain in writing why your coverage has been suspended. Check whether the stated reason is correct and whether it appears in the policy conditions.2. File an objection
You can object to the suspension. Explain why the measure is unjustified or disproportionate. Refer to your policy and indicate that you are fulfilling your obligations.3. Request immediate reinstatement
If the insurer has no good reason, you can demand that coverage be restored immediately. Sometimes this is necessary to prevent further damage.4. File a complaint with KiFiD
Are you unable to resolve the matter with the insurer? File a complaint with KiFiD. The Financial Services Complaints Institute can decide that the suspension is unjustified and that coverage must be reinstated.5. Start proceedings
If that also does not lead to a result, you can enforce through the court that the insurance is valid again and that the damage is compensated. We can fully represent you in this matter.What can Arslan Advocaten do for you?
- We assess whether the suspension is legally permitted.
- We file objections with the insurer.
- We start KiFiD proceedings or court proceedings if necessary.
- We recover our costs from the insurer, so our help can be free of charge for you.