Filing an objection against an insurer is necessary when your claim for damages is denied, your benefit is discontinued or your policy is terminated. An insurer has legal expertise and internal protocols, but that does not mean a decision is automatically correct. A well-founded objection can make the difference between final rejection and full payment. In this article you will read in detail how this works legally, which rules apply and how to position yourself strategically.
When is an objection against an insurer possible?
An objection is possible as soon as you receive a written decision with which you disagree. Think, for example, of:
- Complete refusal to pay an insurance indemnity
- Partial payment that is lower than expected
- Termination of your insurance policy
- Suspension of payments
- Registration in the CIS or EVR
- Accusation of fraud or breach of the duty to disclose
In all these situations it is crucial to lodge an objection in time. If you wait too long, your legal position may be weakened.
The legal framework for objections against an insurer
Your objection is assessed within the framework of the Burgerlijk Wetboek (Dutch Civil Code), in particular the provisions on insurance contracts (article 7:925 BW et seq.). In addition, reasonableness and fairness play an important role.
Duty to disclose (artikel 7:928 BW)
Insurers regularly rely on breach of the duty to disclose. They allege that incorrect or incomplete information was provided when the insurance was taken out. The following must be examined:
- Was the information provided actually relevant to the risk?
- Did the insurer ask specific questions?
- Is there intent to deceive?
Not every inaccuracy justifies a complete refusal to pay.
Allocation of the burden of proof
In such an objection the burden of proof rests to a large extent on the insurer when it invokes an exclusion or fraud. The insurer must demonstrate concrete facts and circumstances. A mere suspicion is insufficient.
Interpretation of policy terms
Ambiguous clauses in consumer insurance policies are generally interpreted in favour of the insured. Therefore the objection often focuses on the interpretation of the policy terms.
Objection against an insurer in case of suspected fraud
One of the most serious situations is when the insurer suspects fraud. In that case, in addition to refusal to pay, registration may follow in the Centraal Informatie Systeem (CIS) or the Extern Verwijzingsregister (EVR).
The objection in fraud cases focuses on:
- The seriousness of the suspicion
- The proportionality of the measure
- The application of audi alteram partem (hearing both sides)
- The balancing of interests between the parties
More information about privacy rights can be found at the Autoriteit Persoonsgegevens (Dutch Data Protection Authority).
See also our page about Removing a CIS registration (Centraal Informatie Systeem – CIS) and Removing an EVR registration (Extern Verwijzingsregister – EVR).
Step-by-step plan: effectively filing an objection against an insurer
Step 1: Request the complete file
Request all internal notes, expert reports and correspondence. Without the file, an effective objection is virtually impossible.
Step 2: Analysis of coverage and evidence
Examine whether the exclusion on which the insurer relies is legally tenable. Often analysis shows that the coverage is broader than claimed.
Step 3: Legally reasoned letter
Your objection must address specific statutory provisions, policy terms and pieces of evidence. A general response is insufficient.
Step 4: Negotiation or litigation
If your objection is rejected, a complaint to the Kifid (Klachteninstituut Financiële Dienstverlening — Financial Services Complaints Institute) or civil proceedings may follow.
Kifid or civil court?
After filing an objection you can choose from:
- Complaint procedure at the Kifid
- Full trial before the civil court
- Summary proceedings (kort geding) in case of urgent interest
The Kifid is more accessible, but is not always suitable for complex evidentiary disputes. Civil proceedings offer more scope for taking evidence. The right choice depends on your file.
More information about litigation can be found on our page about procedural law.
Limitation and complaint periods
Timelines play an important role in the objection process. Claims under insurance generally prescribe three years after you become aware of the damage and the liable party. In addition, policy terms may contain forfeiture periods. Acting in time is therefore essential.
Case example: objection against insurer in water damage case
A client received a rejection on the grounds of alleged neglected maintenance. In the objection it was demonstrated that there had been a sudden pipe burst. After legally substantiated correspondence, full payment followed.
Case example: objection against insurer for breach of the duty to disclose
An entrepreneur was faced with termination of his policy due to alleged incorrect information at the time of application. In the objection it was substantiated that the alleged omission was not relevant to the insured risk. The insurance was reinstated.
Strategic tips when objecting to an insurer
- Always respond in writing
- Request concrete pieces of evidence
- Do not give extensive statements without legal advice
- Check whether the insurer applies the right to be heard (audi alteram partem)
- Keep all correspondence carefully
A well-prepared objection prevents lengthy proceedings and increases the chance of a favourable outcome.
Costs of legal assistance
In non-personal-injury matters we also work, if you qualify, on the basis of legal aid (“toevoeging”). This means that the Raad voor Rechtsbijstand (Legal Aid Board) reimburses a large part of the lawyer’s fees when your income is below the statutory threshold. You then pay only a limited personal contribution.
We assess in advance whether you are eligible for publicly funded legal assistance.
Conclusion: this requires legal precision
A dispute with your insurer can have significant financial consequences. Insurers have specialised departments and legal knowledge. A well-substantiated objection against an insurer, based on legislation, policy terms and evidence, greatly increases your chance of success.
Would you like to know whether an objection against an insurer is promising in your situation? You can contact us for an assessment of your file.
Legal deep dive: burden of proof, Kifid procedure and data registration in objections
The legal standard of article 7:930 BW regarding the duty to disclose
When an insurer relies on breach of the duty to disclose in an objection procedure, the legal burden of proof remains with the insurer. Pursuant to article 7:930 of the Burgerlijk Wetboek (BW), the insurer must demonstrate not only that the policyholder provided incorrect or incomplete information in the application about facts of which he knew or ought to have known, but also that the insurer, if properly informed, would not have concluded the contract or would have concluded it on different terms. This requires an objective standard in which it is assessed whether a reasonably acting insurer would have refused the risk.
If there is no intent to deceive on the part of the insured, and the non-disclosure is not related to the eventual materialisation of the risk, the right to a complete refusal of payment lapses. Recent legislative amendments, including specific rules regarding premium refund in good faith, strengthen the consumer’s legal position in cases of partial non-performance. A successful objection therefore requires a sharp legal analysis of the exact policy questions and the degree of causation between the alleged inaccuracy and the loss.
The formal route and dispute resolution via the Kifid
Before a dispute with an insurer can be submitted to the Klachteninstituut Financiële Dienstverlening (Kifid), procedural law requires that the insurer’s internal complaints procedure has been fully exhausted. The Kifid assesses the insurer’s decision against applicable codes of conduct, legislation and standards of reasonableness and fairness. Strict deadlines apply for filing a complaint after the insurer has made its final position known.
When conducting an objection and complaint procedure it is essential to take into account the nature of the decision of the Kifid Disputes Committee:
- Binding decision: Parties agree in advance that the Disputes Committee’s decision is binding, which in principle precludes recourse to the civil court.
- Non-binding decision: If a non-binding procedure is chosen, either party may still commence civil proceedings if the outcome is unsatisfactory.
- Evidence: Complex cases requiring witness hearings or extensive expert investigations are generally less suitable for the written Kifid procedure and call for a judicial civil forum.
Proportionality and privacy: combating unjust CIS and EVR registrations
A serious consequence of a rejected claim or an alleged integrity incident is registration in the database of Stichting CIS or in the Extern Verwijzingsregister (EVR). Such registrations have far-reaching consequences for the future insurability of the person concerned. Under the law and applicable privacy rules pursuant to the Algemene Verordening Gegevensbescherming (AVG — GDPR), an insurer must strictly observe the principles of proportionality and subsidiarity when taking such a measure. A mere suspicion or an insufficiently substantiated suspicion of fraud never justifies a prolonged registration.
In the objection against a CIS or EVR registration it must be legally demonstrated that the alleged conduct does not meet the strict criteria of the Protocol Incidentenwaarschuwingssysteem Financiële Instellingen. If the insurer refuses to rectify the registration, in addition to a complaint at the Kifid a request for access, rectification or deletion may be submitted under the AVG, or an urgent application for deletion may be sought by way of summary proceedings before the civil court.
For the current principles you can consult the statutory regulation on wetten.overheid.nl.
See also
- Verzekeringsrecht advocaat: deskundige hulp bij conflicten met verzekeraars
- Klacht indienen bij het KiFiD – uw rechten, stappenplan en tips
Frequently Asked Questions
When can I file an objection to a decision by my insurer?
You can file an objection as soon as you receive a written decision with which you disagree, such as a rejection of your claim or termination of your policy. It is important to do this in a timely manner; otherwise your legal position may worsen.
How is an objection against an insurer assessed under the law?
An objection is assessed within the framework of the Burgerlijk Wetboek (Dutch Civil Code), particularly the provisions on insurance contracts, and the standards of reasonableness and fairness play a major role. The interpretation of policy terms and the duty to disclose are also relevant.
What should I do if the insurer invokes fraud in my case?
In the case of suspected fraud the insurer must demonstrate concrete facts and circumstances, not merely a suspicion. As a client you can object by arguing that the seriousness of the suspicion and the proportionality of the measure are disproportionate.
How is the interpretation of policy terms treated in an objection?
Ambiguous policy terms are generally interpreted in favour of the insured. In an objection you should focus primarily on the interpretation of the policy and the relevance of the information provided at the time the insurance was taken out.
