Resolving Life and Health Insurance Disputes in Turkey

The most common disputes in life and health insurance are based on an allegation that the risk disclosure made when the contract was concluded was incomplete or inaccurate; whether this allegation is well-founded directly determines whether compensation will be paid.

The Insured's Disclosure Obligation

Under Article 1435 et seq. of the Turkish Commercial Code (TTK), the policyholder is required, when the contract is concluded, to accurately and fully disclose matters known to them that are material to the insurer's assessment of the risk. Information such as medical history and smoking or alcohol use falls within this scope.

The Consequence of Breaching the Disclosure Obligation

If a breach of the disclosure obligation is found to have been intentional, the insurer can withdraw from the contract and refuse to pay compensation even where the insured risk has materialised. Where the breach was not intentional, the insurer's rights are regulated differently and more narrowly under the TTK; this distinction directly affects the outcome of the dispute.

Pre-Existing Condition Objections in Health Insurance

Another common issue in health insurance disputes is the insurer refusing payment on the ground that the condition underlying the treatment claim was a pre-existing (undisclosed) condition predating the policy's start date. The burden of proving this allegation rests, as a rule, with the insurer, who must establish with concrete evidence that the insured was aware of the condition before the policy began.

Beneficiary Disputes in Life Insurance

In life insurance, disputes can also arise over who is entitled to the payout upon the insured's death, relating to the designation of a beneficiary; if no beneficiary is clearly designated in the policy, the payout is, as a rule, paid to the insured's legal heirs.

Practical Recommendations

When completing the policy application form, disclose your medical history fully and accurately — a deficiency that comes to light later can lead to the compensation claim being denied in its entirety. If you face a denial of payment, assess together with a lawyer whether the stated grounds are supported by concrete medical records.

This article is for informational purposes only and does not constitute legal advice. Please contact our team regarding your specific situation.