Question of law: “My insurance requires the medical file of my deceased brother”


Me Laurent Rebyrol’s response. “Your question raises the legal issue of access to medical records by an insurer upon the death of its insured. It also highlights the difficulties very often encountered by certain beneficiaries of life insurance to recover the capital provided for in the contract after the death of the subscriber. Above all, it should be noted that death insurance is a provident contract that allows financial capital to be transmitted to identified beneficiaries. To grant cover, the insurer must assess and therefore know the level of risk that it will be required to guarantee. This assessment involves the establishment of a medical health questionnaire which is given when the contract is taken out by the insurer to the subscriber.

Most of the time, a simplified medical questionnaire is given which will provide an overview of the subscriber’s health. But it can also be given a medical questionnaire by pathology or apparatus, more specific, if the first form reports a specific disease. Some provident insurers offer death insurance without a medical questionnaire, but this is rare, and entails a higher annual premium. These contracts are generally reserved for people who have pathologies that significantly increase the risk of death, who cannot take out conventional contracts. .

The insurance did accept the provident cover requested on the basis of the medical questionnaire which appears to have been presented to it, and which revealed to it the state of health of the deceased. On this sensitive issue, the Minister of Social Affairs, Health and Women’s Rights published a response in the JO of the Senate on September 3, 2015. After recalling that the provisions of the law of March 4, 2002 relating to the rights of patients, provide that medical secrecy does not preclude information concerning the deceased from being delivered to their heirs, insofar as it is necessary for them to know the causes of death, to defend the memory of the deceased or to assert their rights, unless otherwise expressed by the person before his death, the answer specifies that insurance companies are not authorized to obtain information covered by medical secrecy.

On the other hand, no legislative or regulatory provision prevents the heirs of the deceased, in order to assert their rights to benefit from the capital of the death benefit insurance, from accessing the medical file of the deceased person, and then transmitting the necessary information to their insurance company.

It is thus possible for you as a beneficiary, and unless the deceased manifests otherwise before his death, to have access to his medical file and then to transmit the information to the insurance company”.

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