In 2013, while on vacation, I suffered a knee injury at a soccer match. The emergency room doctor found only the bruise and told him to come in two weeks. After this time, the leg continued to hurt, but the doctor insisted it was just a bruise and it took time for it to pass. Finally, in early 2014, I went for an MRI privately because my knee was often painful and unstable. It turned out that I had torn ligaments and a damaged meniscus. I have a knee reconstruction surgery scheduled for May 2015, but during that time I changed my insurer. My question is which insurer should I claim from, the one I had during the accident or the new one I have had since January this year. I am also afraid that the first misdiagnosis (as a contusion) will have an impact on the positive consideration of my application to the insurer.
In this case, you should definitely contact a lawyer who, reading the provisions of both insurance contracts, will be able to assess the situation.
Taking into account the provisions of the Civil Code (art. 814 paragraphs: 1, 2 and 3), in my opinion, some insurance liability should be undertaken by the previous insurer. It is also important that the policyholder is obliged to provide the insurer with all known circumstances that the insurer asked about in the offer form or before concluding the contract in other letters. If the policyholder concludes the contract through a representative, this obligation also rests with the representative and also covers circumstances known to him. If the insurance contract stipulates that during its duration, changes to the circumstances listed in a paragraph should be reported, the policyholder is obliged to notify the insurer about these changes immediately after receiving the information about them.
Legal basis: Civil Code Act (Journal of Laws of 2014, item 121 as amended)
Remember that our expert's answer is informative and will not replace a visit to the doctor.
Przemysław GogojewiczIndependent legal expert specializing in medical matters.
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