Information of the Consequences of the Violation of the Disclosure Obligation
Dear Customer,
So that we can check your application/your demand for an offer
properly, it is necessary for you to answer the enclosed questions
truthfully and completely. Such circumstances which you may
deem to be trivial should also be included.
If you or any of the persons to be insured do not wish to disclose
information in this instance, you may remedy this situation by
writing to the Board of Directors in Stuttgart within seven days.
Your details will be treated in the strictest confidence in any case.
Please note that you will jeopardise your insurance cover if you give
incorrect or incomplete information. Please see the information
below for more detailed information on the consequences of
violation of the disclosure obligation.
What pre-contractual disclosure obligations exist?
You are obliged, prior to submission of your contractual declaration,
to disclose truthfully and completely all material circumstances
known to yourself, which we have requested in writing. If we
request material circumstances in writing after your contractual
declaration but prior to contract acceptance, you are obliged to
disclose to this extent.
What consequences may occur if a pre-contractual disclosure obligation is violated?
1. Withdrawal and lapsing of insurance cover
If you violate the pre-contractual disclosure obligation, we can
withdraw from the contract. This does not apply if you can prove
that there is neither malice aforethought nor gross negligence.
In the event of gross negligent violation of the disclosure
obligation, we have no right to withdraw if we had concluded the
contract in the knowledge of the undisclosed circumstances, even in
accordance with other conditions.
There is no insurance cover in the event of withdrawal. If we
declare withdrawal after occurrence of the insurance case, we
remain obliged to provide benefits if you prove that the
undisclosed or incorrectly disclosed circumstance was the cause of
- neither the occurrence or establishment of the insurance case
- nor the establishment or the extent of our benefit obligation.
However, our benefit obligation does not apply if you have
fraudulently violated the disclosure obligation.
In the event of a withdrawal, we are entitled to that part of the
premium which corresponds to the contractual period which has
elapsed up to the implementation of the withdrawal declaration.
2. Termination
If we are unable to withdraw from the contract because you have
only violated the disclosure obligation with slight negligence, we
can terminate the contract giving one month’s notice.
Our termination right is excluded if we had concluded the contract
in the knowledge of the undisclosed circumstances, even in
accordance with other conditions.
3. Contract amendment
If we are unable to withdraw or give notice to terminate because
we had concluded the contract in the knowledge of the undisclosed
risk factors, even in accordance with other conditions, the
other conditions become part of the contract at our request. If you
have negligently violated the disclosure obligation, the other
conditions will become part of the contract retroactively. This may also
lead to us not being obliged to reimburse the costs for events
insured already having occurred or occurring in future if conditions
have been or are the cause for these which have not been mentioned
or which have not been mentioned correctly. If you have
inadvertently violated the disclosure obligation, we are not entitled
to amend the contract.
If the premium increases by more than 10 % as a result of the
contract amendment or if we exclude the risk cover for the
undisclosed circumstance you can terminate the contract within one
month from receipt of our letter on the contract amendment.
We will refer to this right in our letter.
4. Exercising of our rights
We can only invoke our rights to withdrawal, termination or contract
amendment within one month in writing. This period begins
on the date on which we gain knowledge of the violation of the
disclosure obligation which justifies our invoked right. In exercising
our rights, we have to state the circumstances on which our declaration
is based. We can state further circumstances for justification
retroactively if the period for this purpose in accordance with
Clause 1 has not expired.
We cannot invoke the rights to withdrawal, termination or contract
amendment if we had knowledge of the undisclosed risk factor or
the inaccuracy of the disclosure.
Our rights of revocation, cancellation and modification of the contract
expire after the period of three years after the conclusion of
the contract. This does not apply for events insured against which
have occurred before this period. The period is ten years if you
have violated the obligation of disclosure intentionally or fraudulently.
5. Representation by another person
If you are represented by another person for the conclusion of the
contract, the knowledge and malevolence of your representative
as well as your own knowledge and malevolence have to be considered
as far as the obligation of disclosure, the revocation, the
cancellation, the modification of the contract and the preclusive
time limit are concerned for the execution of our rights. You may
only refer to the fact that the obligation of disclosure has not been
violated intentionally or grossly negligently if neither your
representative nor you may be charged for it.
HALLESCHE
Krankenversicherung auf Gegenseitigkeit
HALLESCHE Krankenversicherung auf Gegenseitigkeit. VG 13E – 01.21
Were medical examinations or treatments carried through during the last 3 years or are they advised or envisaged?
You do not need to list the following diseases/examinations if they have healed completely and without consequences and no follow-up treatments are planned or advised or if they are listed under "Chronic diseases":
Head (ears, eyes, mouth/throat, nose, upper respiratory tract): conjunctivitis, common colds/colds, hordeolum, flue, stomatitis, oral thrush, nasal polyps operated, nasal septal deviation operated, ear wax
Spinal column (spine): back discomfort (occurred once and healed for at least 12 months), no prolapse of an intervertebral disc (herniated disc/slipped disc) or no spinal misalignment
Genitourinary system/stomach/intestine (bowel): contraception, inflammation of the bladder (occurred once or twice and healed for at least 6 months), gastrointestinal infections/gastroenteritis, abdominal influenza/gastric flu, pregnancy and childbirth, sterilization
Prevention: vaccinations, routine examinations without findings, preventive medical check-ups without findings
Externally visible: skin fungus, insect stings (non allergic), nail bed inflammation (occurred once or twice), ingrown nails (occurred once or twice), nail fungus/onychomycosis (healed for at least 12 months), superficial injury (haematoma/bruise, contusion, cut and laceration, dislocation, sprain, strain), sunburn, burn (1st to 2nd degree, without scarring)
General (diseases, treatments and examinations): contraception, common colds/colds, flue, vaccinations, bone fractures without foreign material (e.g. pins, plates, rods or screws), food poisoning, superficial injury (haematoma/bruise, contusion, cut and laceration, dislocation, sprain, strain), routine examinations without findings
Chronic diseases: allergy (animal hair), allergy (drugs), lactose intolerance, moles (benign)
Your answer: