Porto Court of Appeal
Case No. 363/24.2YRPRT
Date: 20 March 2025
Link to DGSI website HERE
Keywords: Annulment | Arbitral Award | Institutional Rules
Summary:
I. Under Article 39(4) of the Voluntary Arbitration Law, written adherence to the rules of an arbitration centre is sufficient to meet the requirement of express consent.
II. Acceptance of the possibility of appeals entails that all procedural rules, in particular those regarding the finality of interlocutory decisions and the lodging of appeals, are applicable.
III. Consequently, the raising of issues that have already become formally res judicata in the proceedings is time-barred.
IV. The determination of whether a contractual clause is applicable and how it should be interpreted constitutes a question of law, which cannot be resolved as a matter of fact.
V. In the event of renewal of an insurance contract, the conditions communicated to and accepted by the insured will, in principle, be valid.
VI. However, if the insurance policy specifies that an additional rider is required, and if the alteration is material and significant, then in the absence of such rider the initial version of the agreement remains binding upon the parties.
VII. If, in fact, the reason for the refusal to finance the medical procedure lies in a choice by the insurer not to cover such procedures, whether within or outside the network, this constitutes a contractual exclusion.
VIII. Yet such an exclusion is invalid, as it was neither set out in the agreement nor the subject of any disclosure.
IX. The only criterion that could have legitimised it under the literal terms of the policy would have been “good clinical practice,” which was not even alleged.
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