The mutual insurance company in the context of the hospitalisation service linked to its compulsory supplementary insurance covers all pre-existing conditions within the limits of its cover, but it should be remembered that given the acceptable fixed amount of the contribution, the cover is more limited.

Insurers, as well as mutual societies offering insurance products, are subject to the following rules:

  • logically, where the symptoms of an illness had not yet appeared at the time the contract was taken out, both the insurer and the mutual society cannot, of course, refuse insurance cover;
  • if the symptoms of the illness had already appeared at the time the contract was taken out and the illness was not diagnosed within the period of 2 years, unintentional omissions or inaccuracies may no longer be invoked at the end of this period of 2 years from the entry into force of the contract
     (art. 205, law of 4 April 2014 on insurance)

And for the disabled and chronically ill...

At present, a candidate policyholder suffering from a chronic illness or disability and who has not reached the age of 65, is entitled to health care insurance, it being understood that the costs related to the illness or disability existing at the time the insurance contract is taken out may be excluded from the cover.

The premium must be equal to that which would be claimed from the same person, if that person was not chronically ill or disabled.

(art. 206, Law of 4 April 2014 on insurance)

Last update
15 December 2020