Can my health insurance in Malta refuse to cover a pre-existing condition?
- 13.07.2026
I purchased an insurance policy in Malta based specifically on my broker’s recommendation, but it turns out the policy doesn’t actually cover a type of risk I clearly explained to them was important to me at the time. Now that I need to make a claim related to exactly that risk, I’m being told it’s excluded. Does my broker bear any responsibility for this?
Insurance intermediaries, including brokers, operating in Malta are regulated under the Insurance Distribution Act, Chapter 487 of the Laws of Malta, which imposes specific professional obligations regarding how they advise and assist clients, including a duty to properly understand a client's actual needs and to recommend a policy that is genuinely suitable given those disclosed needs, meaning if you clearly communicated a specific risk you wanted covered and the broker nonetheless recommended a policy that excluded exactly that risk without properly flagging this gap to you, this could potentially constitute a breach of their professional obligations, giving rise to a claim against the broker separately from your dispute with the insurer itself. Gather any evidence of what you actually told the broker about your needs and concerns at the time, such as emails, messages, or notes from your discussions, since this would be central to establishing that the broker had clear knowledge of your specific requirement and still failed to recommend suitable coverage. Given both the insurance claim issue with your insurer and this potentially separate issue regarding your broker's advice, it would be worth consulting a lawyer to properly assess whether you have grounds for a claim against the broker specifically, in addition to pursuing the underlying claim or complaint regarding your policy with the insurer.
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