Written by Onur Arslan, lawyer at Arslan Advocaten, registered with the Netherlands Bar for employment law and personal injury. Updated: 27 September 2026. This page concerns Dutch law.
What help do you need with your insurer?
A dispute about payment requires a different approach from a warning-register entry or disagreement with a legal expenses insurer. Choose the route that fits:
- Loss or cover refused: below we explain how to assess the refusal, policy terms and evidence.
- Fraud allegation or registration: explore EVR assistance. First establish which entry was made and by whom.
- Your legal expenses insurer will not continue: read about the dispute-review clause for disagreement about strategy or prospects. For service complaints, see the legal expenses complaint route.
Discuss your insurance dispute. Tell us which insurance is involved, what the insurer decided and whether a deadline or hearing is approaching. We will discuss which policy documents, letters and reports are needed. Some further-reading links on this page lead to Dutch articles.
My insurer will not pay: what should I do?
If a claim is refused or payment is delayed, request the decision, applicable terms and supporting documents. Arslan Advocaten can assess whether the dispute concerns coverage, cause, amount or alleged fraud. We then discuss the appropriate response or procedure and costs. Mention approaching deadlines or hearings immediately.
Common refusal grounds require different enquiries:
| Ground | Actual issue |
|---|---|
| Information omitted when applying | Whether disclosure was required and whether there was intent |
| An exclusion applies | Its interpretation and application to the facts |
| Outside the definition of cover | Whether the event falls within the insured risk |
| Late notification or insufficient cooperation | Whether a reasonable interest of the insurer was prejudiced |
| Amount disputed | Expert assessment and an independent counter-assessment |
| Suspected fraud | Whether the allegation is sufficiently established and registration proportionate |
Further reading: car stolen but the insurer refuses to pay.
Which steps fit your insurance dispute?
Start with the file and precise refusal ground. An internal complaint is normally needed before Kifid can consider your case. Kifid is not generally a mandatory step before court. Urgency or an approaching deadline may require immediate assessment of the appropriate procedure.
- Collect the policy schedule, applicable conditions, application, refusal and investigation reports.
- Separate coverage, valuation and registration issues; they may require different evidence.
- Check limitation and contractual expiry periods and preserve your claim in time. Keep proof that the relevant communication reached the correct party.
- Respond with reasons and use the internal complaint procedure where appropriate.
- Choose correspondence, Kifid or court according to jurisdiction, urgency, deadlines and costs.
What must I disclose when taking out insurance?
Article 7:928(1) of the Dutch Civil Code requires disclosure before conclusion of facts you know or ought to know and understand or ought to understand may influence the insurer’s decision. The insurer needs information held by you to assess risk.
That duty has limits which a refusal letter may not fully explain:
| Limit | Rule |
|---|---|
| What the insurer already knows | Article 7:928(4): no duty to disclose facts the insurer knows or ought to know, or facts which would not have led to a less favourable decision |
| Criminal history | Article 7:928(5): only events within eight years before conclusion and only following an express, unambiguous question |
| What was not asked | Article 7:928(6): with an insurer’s questionnaire, it generally cannot rely on unanswered questions, unasked facts or an incomplete answer to a broadly worded question, except intentional deception |
| Medical examinations | Article 7:928(4) also excludes information which the Medical Examinations Act prohibits asking about |
The questionnaire protection is particularly relevant because applications and health declarations commonly use one. If the insurer did not ask, that omission generally cannot be held against you, subject to the statutory exception. In ECLI:NL:RBMNE:2026:3154, the court also addressed the special nature of the insurance non-disclosure rules in relation to mistake.
The insurer has a deadline too. Article 7:929(1) requires it to notify you of the non-compliance and possible consequences within two months of discovery if it wants to rely on those consequences. Late or incomplete notice can undermine that defence. Source: Dutch Civil Code, Articles 7:928–929.
The insurer alleges non-disclosure: what are the consequences?
Not every breach results in no payment. Article 7:930 provides different outcomes according to what the insurer would have done with correct information.
| Situation | Consequence | Basis |
|---|---|---|
| The omitted fact is irrelevant to the risk as it materialised | Generally full payment, also considering the exceptions in paragraphs 4 and 5 | 7:930(2) |
| A higher premium or lower insured amount would have applied | Proportionate reduction | 7:930(3) |
| Different conditions would have applied | Payment as if those conditions formed part of the contract | 7:930(3) |
| No insurance would have been concluded | No payment | 7:930(4) |
The rule preserving payment where the fact was irrelevant must be read with the exceptions for refusal to insure altogether and intentional deception. Lack of a link to the particular loss therefore does not invariably require payment. Paragraph 4 also protects a policyholder acting in good faith: where the insurer would not have insured at all, that policyholder does not owe premium under that provision.
The insurer must substantiate the alleged disclosure duty, the relevance you knew or should have understood, and its actual underwriting response. Merely asserting “we would not have insured” is generally insufficient. ECLI:NL:GHARL:2018:11004 illustrates the need for adequate reasons and the exclusion of facts already known or which should have been known.
Illustration, not a case handled by our firm: someone discloses knee complaints but omits earlier treatment thought to be finished. Years later, an unrelated condition leads to a claim. The questions are what was asked, relevance to the materialised risk and what proper disclosure would have changed: no cover, a higher premium or different conditions. Each answer has different legal consequences.
Further reading: claim refused for non-disclosure.
Intentional deception or an innocent inaccuracy?
Without intent to deceive, the Article 7:930 framework determines whether payment remains full, reduced, adjusted or unavailable under the applicable provision. Intentional deception has more serious consequences: refusal, possible immediate termination and a separate assessment of warning-register entries. Those measures are not interchangeable or automatic.
Article 7:930(5) addresses intentional deception, as do Article 7:929(2) on immediate termination, Article 7:928(6) on questionnaire protection and Article 7:941(5) on deception during claim handling.
Intent is a demanding issue. ECLI:NL:GHARL:2023:10091 describes the intention to induce the insurer to enter the contract by withholding relevant known information. ECLI:NL:RBZWB:2020:6911 refers to conduct contrary to what the person knows to be true. An error alone does not establish that intention.
- Misunderstanding or narrowly interpreting a question is not, by itself, intentional deception.
- Forgetting an old matter considered resolved is not automatically fraud.
- A careless or incomplete claim form requires assessment of the surrounding facts.
Deliberately presenting a false loss amount may be different. The dividing issue remains intention, not simply inaccuracy. A substantiated fraud finding can have consequences beyond this claim through incident and EVR registration, affecting access to financial services for years.
How are unclear policy terms interpreted?
Standard policy terms are commonly interpreted by their wording and objective context. Where an insurer drafted an ambiguous clause unilaterally, interpretation against the drafter may be appropriate. This is called contra proferentem; it does not turn a clear clause into an ambiguous one. See the Advocate General’s opinion ECLI:NL:PHR:2017:185.
For consumers, Article 6:238(2) requires clear, intelligible terms and favours the consumer’s interpretation where meaning is doubtful. Article 6:233 also addresses unfair terms and failure to provide a reasonable opportunity to examine them.
Interpretation considers wording in the context of the whole policy and explanatory material, ordinary meaning, purpose and the nature of the insurance; see ECLI:NL:PHR:2022:229. Compare an exclusion closely with the facts rather than accepting an interpretation broader than its wording.
Keep both the conditions at inception and those applying at the loss date. If the insurer changes terms to your disadvantage, Article 7:940(4) provides a termination right tied to the change and notification, subject to the applicable statutory framework.
Exclusions and excess: what may the insurer rely on?
An insurer may define the boundaries of cover. A primary coverage definition identifies the insured risk; an exclusion removes something otherwise within cover. This distinction affects interpretation and the burden of proof. A simple appeal to fairness does not rewrite the insured risk; assess the exact provision and circumstances. ECLI:NL:RBAMS:2009:BJ9979 discusses primary cover.
The insurer normally needs to establish the facts supporting an exclusion. Common disputes include:
| Exclusion | Question |
|---|---|
| Intent or recklessness | Does proven conduct meet the policy wording? |
| Alcohol or drugs | Is use established and the clause sufficiently clear? |
| Security or prevention failures | What was required and communicated? |
| Poor maintenance or wear | Did that cause the loss, or did an insured event? |
| Existing defects or complaints | What is the link to the reported loss? |
| Breach of policy duties | Is there a valid forfeiture clause and are its conditions met? |
An excess is different: an agreed amount remains for your account. Disputes may concern whether it applies per event, item or policy year and whether there was one event or several. Basic health insurance also has a statutory excess; check the amount applicable in the year of treatment.
For notification and information duties, Article 7:941(4) restricts forfeiture clauses to situations where the insurer’s reasonable interests were prejudiced. A policy cannot simply remove those protections.
How quickly must I report a loss?
Article 7:941(1) does not prescribe one universal number of days. Notify the insurer as soon as reasonably possible after becoming, or being expected to become, aware of the insured risk materialising. Policies may specify notification requirements such as 24 hours for theft or another period. Check the actual terms and statutory safeguards.
| Paragraph | Article 7:941 rule |
|---|---|
| 1 | Notify as soon as reasonably possible |
| 2 | Provide necessary information and documents within a reasonable time |
| 3 | Non-compliance may reduce payment by the loss the insurer suffered as a result |
| 4 | Contractual forfeiture requires prejudice to a reasonable interest |
| 5 | Intentional deception may forfeit payment, except insofar as the deception does not justify forfeiture |
Late notification therefore does not automatically mean no payment. Under paragraph 3, identify the actual disadvantage caused by the delay. Without that disadvantage there is generally nothing to deduct on that ground.
Much of this protection is mandatory. Article 7:943(2) prevents detrimental departure from, among others, Article 7:941(1), (2), (4) and (5). Paragraph 3 extends protection for consumers to Articles 7:928–930 where the policyholder acts outside a profession or business.
May I appoint my own loss expert?
If the amount of insured loss is disputed, an independent expert may help. Article 7:959 addresses reasonable loss-assessment costs. In private non-life insurance, the protection cannot be limited in advance to a fixed cap or the insurer’s expert fee. Both engaging the expert and the costs must be reasonable. Work to establish coverage requires a separate assessment. Clarify the instruction, budget and any binding effect beforehand.
Policies may provide assessment by agreement, one jointly appointed expert or two experts, one selected by each party. ECLI:NL:RBAMS:2025:6246 illustrates that structure. An appointment agreement may provide for a third expert to decide between the valuations within their bounds; see ECLI:NL:RBROT:2017:7416.
- Raise it in time: seek a counter-assessment before accepting final settlement. Later options depend on what was agreed.
- Check binding effect: an expert valuation may bind the parties on amount. Understand the appointment document before signing.
- Separate amount and cover: an agreed loss valuation does not itself decide the legal coverage question.
Illustration, not our firm’s case: after a leak, the insurer’s expert omits damaged subflooring and uses depreciated value where the policy may provide replacement value. The resident signs believing the report is indisputable. The valuation is an assessment, and the policy’s second-opinion route matters. Signing a binding agreement may limit later challenges, which must then be assessed separately.
Read conflicting expert conclusions and refused water-damage claims.
May the insurer terminate my policy?
Termination is subject to statutory and contractual conditions. Article 7:940(3) addresses mid-term termination on agreed grounds sufficiently serious that continued commitment cannot reasonably be required, generally with two months’ notice.
| Situation | Rule to examine |
|---|---|
| Preventing renewal | The notice framework in Article 7:940(1), including two months |
| Mid-term termination by insurer | A contractual power, corresponding right for the insured, a qualifying ground and generally two months’ notice, subject to the deception exception |
| Disadvantageous amendment | Termination right under Article 7:940(4), at the change and in any event for one month after notification |
| Increased health risk in personal insurance | Article 7:940(5) restricts termination or amendment based on deterioration relating to the insured person |
| Discovery of non-disclosure | Article 7:929(2): immediate termination within two months of discovery where the statutory grounds are met, including intent or no insurance at all with correct information |
A mid-term ground must be in the contract and sufficiently serious. “You claim too often” is not a substitute for a valid applicable provision and assessment. In ECLI:NL:GHARL:2023:10092, failure to establish insurance fraud undermined reliance on the corresponding termination clause.
Cancellation may affect future applications asking about previous refusal or termination. Answer the actual questions accurately; an inaccurate answer can create a new disclosure issue. Challenge termination promptly rather than waiting until another insurer refuses cover. Read the consequences of policy cancellation.
Incident Register and EVR after a fraud allegation
A fraud finding can prompt incident and external referral entries. These have separate conditions and consequences. An EVR entry is accessible through the warning system to participating institutions and may affect insurance, finance and sometimes work. Eight years is a maximum under the applicable framework, requiring an individual duration assessment.
A criminal conviction is not required, but processing criminal personal data requires more than a reasonable suspicion: the relevant conduct must be sufficiently established. ECLI:NL:RBROT:2021:4684 discusses that threshold. Proportionality also matters, as illustrated by ECLI:NL:RBDHA:2025:27216 and ECLI:NL:RBNNE:2014:333.
The institution must substantiate its grounds. Your response should address factual allegations and evidence your individual disadvantage. Registration and its duration must both be assessed; neither follows automatically from a refused claim.
See EVR removal and your rights during an insurer investigation.
How do I complain about my insurer?
For Kifid, use the internal complaint process and check admissibility. You may also take an insurance dispute directly to civil court. Binding Kifid advice is subject to limited court review, not automatic reconsideration of the full complaint.
Send a clearly identified formal written complaint with policy number, disputed position and requested outcome. A final response, or the absence of one after eight weeks, may open the Kifid route subject to its rules.
The rules provide alternative filing periods, with the most favourable applicable period governing: three months after a written final position where the provider correctly mentioned that period; one year after first presenting the complaint; or a reasonable period after you knew or should have known of the complaint route. Check Rules 6 and 7 and the particular correspondence.
| Issue | Kifid | Civil court |
|---|---|---|
| Prior step | Normally internal complaint and admissibility checks | No general requirement to go through Kifid first |
| Costs | No consumer fee at the Disputes Committee; appeals may require a fee | Court fees, legal assistance and possible cost consequences |
| Timing | Generally months; not a substitute for urgent protection | Interim proceedings may be available for urgency |
| Evidence | Predominantly written file and the committee’s procedure | Witnesses and experts may be available under procedural rules |
| Binding effect | Depends on applicable choices and rules | Judicial decision, subject to available remedies |
| Appeal | Check Rule 7, financial-interest requirements, exceptions and the six-week appeal period | Ordinary appeal rules where available |
| Choice | Accessible for many policy and service disputes, including eligible registration complaints | Relevant for urgent relief, complex evidence and other suitable claims |
Choose based on the actual problem. Kifid can be accessible for policy interpretation or service complaints; court may be preferable where urgent relief or particular evidence is required. Fraud and EVR disputes are not categorically excluded from Kifid.
Health-insurance disputes generally follow the SKGZ route rather than Kifid. Do not assume the same complaint can proceed at Kifid after court consideration. Preserve limitation separately with an appropriate written claim and proof of receipt. Further reading: the Kifid procedure.
How long do I have? Limitation of an insurance claim
Under Article 7:942(1), a claim for payment generally becomes time-barred three years after the start of the day following awareness that it is due. The starting point is awareness of enforceability, not simply the refusal date.
Paragraph 2 provides interruption by a written communication claiming payment. A new three-year period begins after acknowledgement or unequivocal refusal by the insurer. For liability insurance, paragraph 3 also addresses negotiations with the entitled person or injured party; a new period begins on acknowledgement or unequivocal notice ending negotiations.
The current framework has applied since 1 July 2010. Earlier legislation contained a shorter six-month period after a specified refusal by registered letter. That is not the current general rule. For older cases, transitional law may matter; see ECLI:NL:HR:2019:1529. Article 7:943(2) prevents detrimental departure from Article 7:942.
Legal expenses insurance: may I choose my own lawyer?
Article 4:67(1) of the Financial Supervision Act requires express policy protection for choosing a lawyer or other legally qualified representative in judicial or administrative proceedings, or where a conflict of interest arises. European case law interprets that right broadly, within its legal scope.
| Decision | Significance |
|---|---|
| CJEU 7 November 2013, C-442/12, Sneller/DAS | The insurer cannot make the choice depend solely on its own view that external assistance is necessary |
| CJEU 7 April 2016, C-460/14, Massar | An administrative dismissal-permit procedure before UWV can fall within the right |
| CJEU 14 May 2020, C-667/18 | The right also extends to mediation within the circumstances assessed by that judgment |
Dutch cases including ECLI:NL:RBDHA:2023:12005 and ECLI:NL:RBGEL:2023:7059 apply this framework, including in employment disputes. The stage and nature of the procedure remain important.
Practical problems include the insurer not explaining the right, insisting on internal handling despite an applicable choice right, or rejecting a case for lack of reasonable prospects. For the last situation, policies commonly provide an independent dispute-review mechanism.
- Second opinion on your legal expenses case
- Complaint about the insurer or legal services provider
- Professional error in your case
- Foreign-dispute cover refused
- Dispute-review clause refused
- Choice of lawyer for UWV, objection and appeal
- Your lawyer for dismissal and settlement agreements
- Your lawyer for tenancy disputes or eviction
- Conflict of interest
- Insurer proposes settlement or buying out the claim
- Business legal expenses cover refused
Report the case first, request written confirmation of your choice right and applicable cost limit, and clarify funding before instructing a lawyer. Otherwise incurred costs may not be covered.
Disability insurance for the self-employed: where do disputes arise?
The key question is often incapacity for what: your own occupation as performed or work more broadly? Private disability insurance (AOV) depends on policy wording rather than a single UWV assessment framework. Conditions differ between insurers and policy versions.
ECLI:NL:RBGEL:2025:1321 illustrates a definition involving inability to perform the insured occupation, a medically identifiable disorder caused by illness or accident, and medical consultation. Each element can be disputed.
| Issue | Practical problem |
|---|---|
| Occupation on the schedule | A stated management role may differ from actual manual work; see also ECLI:NL:GHARL:2022:1135 concerning a paving contractor |
| Medical objectifiability | Symptoms without readily demonstrable abnormalities may generate disagreement |
| First year versus later years | Some policies change the assessment after 52 weeks |
| Reassessment | A new medical or occupational assessment may reduce or stop benefits |
- Compare the exact policy definition with your situation, rather than asking only whether you are ill.
- Describe actual duties, hours and physical or mental demands so the occupational assessment reflects your work.
- Request the reports and challenge substantive or procedural weaknesses. An expert opinion is assessable, not beyond dispute.
Illustration, not our firm’s case: a self-employed person develops back problems after moving from the occupation listed on the policy into mainly hands-on work. Benefits stop after the first year. The dispute may turn on the insured occupation and changed assessment criteria, not on whether symptoms are genuine. Start with the policy.
What is my insurance intermediary’s duty of care?
An intermediary must act with the care expected of a reasonably competent professional. Breach may create liability for resulting loss even where the insurer is not at fault. This is separate from the payment claim: did the adviser contribute to the position you are now in?
The standard is discussed in ECLI:NL:PHR:2012:BW1720. Scope depends on the assignment and Article 7:401, as discussed in ECLI:NL:PHR:2020:688.
- Application: were the questions and consequences of incomplete answers explained?
- Advice: did cover fit the circumstances disclosed, and were relevant gaps examined?
- Claim: was notification timely and were deadlines explained?
The duty is not unlimited. The latter opinion also addresses limits where no specific instruction required examination of risk allocation in contracts with customers. Request the intermediary’s file after a refusal: it may establish what was disclosed and to whom.
What does an insurance lawyer cost?
Funding depends on the route: legal expenses insurance, recovery from a liable party, subsidised legal aid or an hourly fee. We offer an initial assessment of your situation without charge before you decide on further work.
| Funding | How it works | Check |
|---|---|---|
| Legal expenses insurance | Covered work, with choice of lawyer where applicable | Written approval and cost ceiling before instruction |
| Liable third party | Reasonable out-of-court costs may be recoverable under Article 6:96(2) | Reasonableness of work and amount; litigation cost rules differ |
| Subsidised legal aid | Application through the Legal Aid Board, normally with a contribution | Income, assets and other eligibility conditions |
| Hourly rate | Privately funded assistance | Estimate and interim arrangements beforehand |
A lawyer identifies the refusal ground, compares policy and facts, assesses proof, protects deadlines and selects the appropriate route. Any further fees are discussed before work is agreed.
About this advice
Arslan Advocaten assists individuals and businesses with refused claims, non-disclosure or fraud allegations, terminated policies, incident and EVR entries, and disability or legal expenses insurance disputes. We negotiate, submit eligible Kifid complaints and litigate where necessary. If the insurer represents someone else, your case may concern liability and, where injured, personal injury.
We have offices in The Hague, Rotterdam, Amsterdam, Utrecht, Tilburg and Eindhoven. Dutch, Turkish, Polish and English assistance is available. Call the office near you or send your question to discuss your position and next step.
Insurance law for clients in Alkmaar
If you live in Alkmaar and face a claim refusal, registration or legal expenses dispute, see insurance assistance for Alkmaar. We assist from Amsterdam. The page explains disputes, documents and complaint routes.
Our offices: visiting addresses and direct numbers
Each office has a direct number. The first discussion is free and confidential; we speak Dutch, Turkish, Polish and English.
| Office | Telephone | Address | |
|---|---|---|---|
| The Hague | 070 4500 300 | Paletplein 80, 2526 GZ Den Haag | [email protected] |
| The Hague (Goeverneurlaan) | 070 4500 300 | Goeverneurlaan 445, 2523 CB Den Haag | [email protected] |
| Rotterdam | 010 311 5500 | Schiedamsedijk 60-A, 3011 EH Rotterdam | [email protected] |
| Amsterdam | 020 747 0055 | Pieter Calandlaan 769, 1069 SC Amsterdam | [email protected] |
| Utrecht | 030 747 0038 | Atoomweg 63, 3542 AA Utrecht | [email protected] |
| Tilburg | 013 747 0022 | Kraaivenstraat 38-10, 5048 AB Tilburg | [email protected] |
| Eindhoven | 040 711 3099 | Croy 7C, 5653 LC Eindhoven | [email protected] |
Unsure which office to choose? Call 070 4500 300 or send your question. We will direct you to the appropriate colleague.
This page provides general information, not advice on your individual case. No rights can be derived from its general explanations.
Explore individual insurance topics
Further reading in Dutch:
- Fire damage the insurer will not reimburse
- Disputing an undervalued total-loss vehicle
- Checking an underinsurance deduction
- Business interruption: turnover and profit loss
- Loss adjustment and independent counter-assessment
- Vehicle damage: pre-existing loss, repair or total loss
- Burglary claim refused: proving ownership and value
- Independent review after a negative prospects assessment
- Inadequate cost limit for choice of lawyer
- Existing-dispute or waiting-period refusal
- AOV: burnout, long COVID and chronic pain
- Challenging the medical or occupational assessment
- Claim against an insurance adviser
- Recourse: when an insurer demands repayment
- Disputing investigation costs and a SODA claim
- Life insurance refuses payment
- Letting, renovation or vacancy and buildings cover
- Refused travel or cancellation claim
- Challenging a prevention-clause refusal
- Late notification and prejudice to the insurer
- Suspended cover for unpaid premiums
- Refused health-insurance authorisation and SKGZ
- Liability insurer refuses cover
- Cyber insurer refuses cover after an incident
- Overlapping policies: who pays?
Targeted guidance for your dispute
EVR after acquittal or discontinuance
Insurance law in Amsterdam
Want to discuss a refusal, calculation or registration? Read about our insurance-law assistance in Amsterdam and which policy documents to prepare.