Most insurance contract disputes do not begin in court; they begin on the signing date: incompletely declared information, exclusion clauses nobody read, and an insurance event file that was not built correctly. The framework is Law on Insurance Business 08/2022/QH15 and guiding Decree 46/2023/ND-CP. This article covers commercial insurance only; compulsory social insurance and health insurance belong to a different legal system and are outside its scope.
Three common groups of causes
The first group is the policyholder’s duty to provide information. When concluding the contract, the policyholder must provide complete and truthful information relating to the insured subject; untruthful or incomplete information is a ground for the insurer to unilaterally terminate the contract or refuse payment when the event occurs. This group causes the most disputes because the fault arises before the risk even occurs.
The second group is exclusion clauses and the determination of the insured event: whether the risk that occurred falls within the insured scope or lands exactly on an exclusion point is the central question of almost every denied claim. The third group is loss assessment and the claim file: inconsistent assessment results, an event file missing original documents, and late payment of insurance money with late-payment interest are the constant friction points between the parties after the event has occurred.
When the insurer refuses to pay: the handling sequence
The first step is to request a written refusal stating the clause basis and the factual basis; a refusal decision without stated grounds cannot be effectively countered. The second step is a complaint inside the insurer with a supplemented file, especially neutral evidence of the event and an independent assessment if the assessment result is the point in dispute. The third step is a reflection to the state management authority for insurance business under the Ministry of Finance when the internal complaint fails.
After these steps, the dispute moves to a dispute resolution mechanism: mediation as agreed by the parties, commercial arbitration only where the parties have a valid arbitration agreement under Law on Commercial Arbitration 54/2010/QH12, or a lawsuit before the competent court. Arbitration is not a default mandatory step in this sequence; without an arbitration agreement, the court is the remaining mechanism.
Limitation period for insurance contract disputes
Law on Insurance Business 08/2022/QH15 no longer contains a separate limitation period for insurance contract disputes: the specialised limitation clause of the 2000 Law on Insurance Business (Article 30, with a three-year period from the moment the dispute arose) was abolished when the 2022 Law replaced the old law, in order to unify the application of the Civil Code. The applicable period is therefore the contract limitation period in Article 429 of Civil Code 23/2015/QH13: three years from the date the entitled person knew or should have known that their lawful rights and interests were infringed — in insurance practice, this point is usually identified from the moment the policyholder receives the written refusal of payment.
The practical consequence is that a prolonged complaint file does not automatically preserve the limitation period: a policyholder pursuing an internal complaint and a reflection to the regulator must still track their own lawsuit limitation point, and when that point approaches, filing the lawsuit to preserve the right cannot be replaced by one more round of complaint.
Frequently Asked Questions
What are the most common causes of insurance contract disputes?
The three main cause groups under Law on Insurance Business 08/2022/QH15 are: first, the policyholder providing untruthful or incomplete information at contracting, leading the insurer to terminate the contract or refuse payment; second, arguments around exclusion clauses and the determination of the insured event; and third, loss assessment, the claim file and late payment of insurance money or compensation. Most disputes originate in the first group, arising from the very first information declaration stage.
What should the policyholder do when the insurer refuses to pay a claim?
The policyholder should follow this sequence: request a written refusal stating the clause and factual bases; complain internally at the insurer with a supplemented file and an independent assessment if needed; reflect the matter to the state management authority for insurance business under the Ministry of Finance if the complaint fails; and only then use a dispute resolution mechanism — mediation, arbitration only where a valid arbitration agreement exists under Law on Commercial Arbitration 54/2010/QH12, or a court lawsuit. In parallel, the policyholder must track the lawsuit limitation period themselves because a prolonged complaint does not preserve it.
What is the limitation period for bringing an insurance contract dispute to court?
The limitation period for bringing an insurance contract dispute is three years under Article 429 of Civil Code 23/2015/QH13, counted from the date the entitled person knew or should have known that their lawful rights and interests were infringed. Law on Insurance Business 08/2022/QH15 no longer contains its own limitation clause (the former rule in Article 30 of the 2000 Law on Insurance Business was abolished), so the old ‘moment the dispute arises’ starting point no longer applies; the policyholder must identify the knew-or-should-have-known point themselves — usually upon receiving the written refusal of payment — and sue within the period.
This article has been quality-reviewed by the FLAW AI Legal Council