The Office of Competition and Consumer Protection commenced explanatory proceedings regarding PZU Życie in June 2017 after notifying the Financial Ombudsman who was receiving complaints from customers. The activities of PZU Życie pertained to persons who concluded individual insurance contracts with it or joined a group insurance scheme – for instance, at the employer’s work establishment. It turned out that the company included clauses in the insurance contracts on the basis of which it could refuse to pay the benefit due to a previous illness of the insured person, even if it was not related to death, specialised treatment or the insured person’s incapacity to work.
The Office’s doubts were raised by the fact that the provisions were too general. An example of a provision: “Liability of PZU Życie S.A. does not cover serious illnesses which occurred or due to which diagnostic and treatment procedure was commenced on the insured person prior to the commencement of liability of PZU Życie S.A. with respect to the insured person”.
A customer who read such a clause was unable to determine himself whether any illness with which he was diagnosed in the past would result in a refusal to pay the benefit.
“Provisions in life insurance contracts must be precise. The customer must know when he will not receive the benefit. It’s good that PZU Życie will change that after our intervention”, says Marek Niechciał, President of the Office of Competition and Consumer Protection.
In the course of the explanatory proceedings PZU Życie narrowed down the impugned clauses. The insurer stated directly that it will not pay the benefit if death, surgery or incapacity to work ensue from a previous illness which actually caused the personal accident. It also indicated which illnesses it has precisely in mind. PZU Życie will change the general terms and conditions of insurance.
