This page is part of the overview of Estonian Supreme Court insurance case law. It collects 6 decisions of the Civil Chamber of the Supreme Court (Riigikohus) on this topic, in chronological order, with a short synthesis of the direction of the case law. The summaries are written in our own words; the judgments themselves are available in Estonian only. Abbreviations and citation conventions are explained on the overview page.
Synthesis
Insurance conditions are normally standard terms (VÕS § 35). The Supreme Court has consistently applied a three-stage review: (1) whether the term became part of the contract (VÕS § 37(1) and (3), including control of surprising and incomprehensible terms); (2) interpretation under VÕS § 39(1), i.e. as a reasonable person in the position of the other party would have understood it, and in case of doubt against the user; VÕS § 39 is a special rule in relation to VÕS § 29 and specialist scientific definitions are not decisive; (3) content review under VÕS § 42, which by virtue of VÕS § 36(3) also applies to contracts concluded in the course of business. An individually negotiated agreement prevails over a standard term (VÕS § 38). A standard term more favourable to the policyholder than the statute is in principle not void.
Decisions
RKTKo 01.04.2003, 3-2-1-34-03
Judgment · paras 8, 10-11 · property insurance; policy data v general conditions; actual intention of the parties · pre-VÕS law
The policyholder insured the second floor of a house; the appellate court inferred from the general conditions that only the whole house could be insured. The Supreme Court held that the parties' actual intention is the primary basis for interpretation and, where the insurer's general conditions, being standard terms, are inconsistent with the agreement reflected in the policy, the agreement prevails. The decision applies the pre-VÕS version of the TsÜS.
Judgment on riigikohus.ee (Estonian)
RKTKo 13.09.2004, 3-2-1-88-04
Judgment · paras 13-15 · standard terms in business dealings; VÕS § 36(3); VÕS § 42(3); VÕS § 44
The appellate court's view that VÕS § 42(3) and § 44 apply only to consumer contracts was wrong: under VÕS § 36(3) the standard-terms provisions also apply between businesses whose places of business are in Estonia. This did not change the outcome, since the courts had found that the terms relied on for refusal (including the driver leaving the scene) were neither unreasonably detrimental to the policyholder nor contrary to good morals.
Judgment on riigikohus.ee (Estonian)
RKTKo 25.10.2006, 3-2-1-90-06
Judgment · paras 15, 17-21 · commercial property insurance; tiered sum insured; individual agreement; VÕS § 38; under- and overinsurance
After a fire the parties disagreed whether a single sum insured stated in the policy or a tiered sum insured provided in the conditions applied. The Supreme Court held that under VÕS § 38 standard terms apply only if the parties have not agreed otherwise. A tiered sum insured may be agreed in standard terms, but only if a reasonable policyholder would clearly understand at conclusion which sum the indemnity will be calculated on, and the term is not unreasonably detrimental. Classifying a case as under- or overinsurance is for the court even if the parties do not invoke it.
Judgment on riigikohus.ee (Estonian)
RKTKo 11.06.2007, 3-2-1-64-07
Judgment · paras 9-13 · definition of storm; interpretation of standard terms; VÕS § 39 v § 29; contra proferentem
Under commercial property conditions, storm damage was an insured event if the wind speed was at least 21 m/s. The Supreme Court explained that VÕS § 39(1) is a special rule in relation to VÕS § 29 and TsÜS § 75: a standard term is interpreted as a reasonable person similar to the other party would have understood it and, in case of doubt, against the user. Interpretation cannot proceed from how the terms are defined by scientists who are not comparable to the policyholder.
Judgment on riigikohus.ee (Estonian)
RKTKo 19.03.2015, 3-2-1-152-14
Judgment · paras 10, 12-13, 15 · cargo insurance; incorporation of standard terms; VÕS § 37(1); VÕS § 39; VÕS § 505
The Supreme Court rejected the argument that the all-risks cargo conditions were not part of the contract, explained the requirements of VÕS § 37(1) and left it to the appellate court on rehearing to assess whether a reasonable policyholder could infer from the policy reference 'Täiskaitse TCT' that the insured risks were defined in the corresponding general conditions; the policyholder did not claim that it had no opportunity to learn their content, and VÕS § 37(3) did not prevent the conditions from forming part of the contract (para 10). The appellate court had, however, misinterpreted the term: standard terms must be interpreted objectively from the perspective of a reasonable counterparty and, in case of doubt, against the user. VÕS § 505 et seq. (cargo insurance risks) are relevant only where the risks are not regulated in the conditions. Under VÕS § 489(1) determining the amount of loss is primarily the insurer's task.
Judgment on riigikohus.ee (Estonian)
RKTKm 02.03.2016, 3-2-1-5-16
Order · paras 9-10 · conditions of VÕS § 475(3); standard term favourable to the policyholder; VÕS § 480(4)
The Supreme Court quashed the rulings that had refused to hear the claim on the ground that the period in VÕS § 475(3) had expired, because the period runs only from the insurer's written notice rejecting the claim. The chamber added that a standard term giving the addressee more favourable treatment than the statute can in principle not be void; the disputed term may have been an agreement on reinstatement value under VÕS § 480(4), favourable to the policyholder.
Judgment on riigikohus.ee (Estonian)