Cases of life insurance and health insurance exclusions in Vietnam

What is life insurance and health insurance?

Based on the provisions of the Law on Insurance Business 2022, health insurance refers to a type of insurance designed to provide the insured with insurance benefits when the insured suffers injury, accident or illness, or needs medical care.

Subjects covered by life insurance and health insurance policies include:

- Human life and life expectancy is the subject matters of a life insurance policy.

- Human health is the subject matters of a health insurance policy.

Insurable interests of life insurance policies and health insurance policies in Vietnam include:

(1) The policyholder shall have insurable interests for the following persons:

- The policyholder himself;

- The policyholder’s spouses, parents, offspring;

- The policyholder’s biological siblings or other persons who are in care or support relationships with the policyholder;

- The persons having financial interests or labor relations with the policyholder;

- Insured persons giving their written consent for purchase of health insurance policies to the policyholder.

(2) At the time of conclusion of an insurance contract, the policyholder must have insurable interests.

For a term insurance contract lasting for more than one year, within 21 days of receipt of the insurance contract, the policyholder may refuse to continue to participate in insurance. Where the policyholder refuses to continue to participate in insurance, the insurance contract shall be terminated and the policyholder shall be refunded insurance premiums that they have paid after deducting reasonable costs and expenses (if any) as agreed upon in the insurance contract; the insurer shall not be obliged to pay insurance indemnity or coverage in case of occurrence of a policy event.

Cases of life insurance and health insurance exclusions in Vietnam (Internet image)

Cases of life insurance and health insurance exclusions in Vietnam

Pursuant to Article 40 of the Law on Insurance Business 2022, insurers and foreign non-life insurers’ branches shall not be exempted from paying insurance indemnity and coverage in the following cases:

- The insured is deceased within 02 years of the first payment of premium or restoration of the insurance contract’s effect;

- The insured’s death is caused willfully and intentionally by the policyholder or the beneficiary, except as prescribed in clause 2 of Article 40 of the Law on Insurance Business 2022;

- The insured’s permanent injury or impairment is caused willfully and intentionally by the insured himself, the policyholder or the beneficiary, except as prescribed in clause 2 of Article 40 of the Law on Insurance Business 2022;

- The insured’s death is caused by serving the death sentence;

- Other cases are stipulated in the insurance contract.

In the cases where there are more than one beneficiary, despite the fact that one or more beneficiaries intentionally cause death or permanent injury or impairment for the insured, the insurer or the foreign non-life insurer’s branch shall have the burden of paying insurance indemnity or coverage to the other beneficiaries under contractual terms and conditions.

When any situation specified in clause 1 of Article 40 of the Law on Insurance Business 2022 arises, the insurer or the foreign non-life insurer’s branch shall pay the policyholder the surrender value of the insurance contract or all of the premiums already paid after deducting any reasonable costs and expenses as agreed upon in the insurance contract, except as provided in clause 2 of Article 40 of the Law on Insurance Business 2022. In case of the death of the policyholder, all of the refunds shall be treated according to law on inheritance.

Mai Thanh Loi

>> CLICK HERE TO READ THIS ARTICLE IN VIETNAMESE