Beijing Financial Court recently upheld a ruling in favor of a woman whose insurance claim had been denied over alleged nondisclosure of her family's cancer history, reinforcing the need for insurers to make clear and valid inquiries.

The case began in August 2022 when the woman, surnamed Huang, purchased a critical illness insurance policy with coverage of 500,000 yuan ($72,468). The policy included a provision to waive future premiums if she was diagnosed with a covered condition.

After Huang was diagnosed with lung adenocarcinoma in January 2025, the insurer rejected her claim, arguing that she had intentionally failed to disclose that her mother had breast and ovarian cancer and that her grandmother had lung cancer during the application process.

Huang took the dispute to the Beijing Chaoyang District People's Court, which ruled in her favor. The court ordered the insurer to pay the full claim, waive future premiums, refund 6,454 yuan and continue to honor the contract.

The insurer appealed to the Beijing Financial Court.

In its recent ruling, the financial court said the insurer's questionnaire specifically asked whether the insured "currently has or has ever had a genetic disease," but made no reference to family cancer history.

The policy's definition of "genetic disease" also did not mention family cancer history. Medical understanding and reasonable consumer interpretation do not equate family cancer history with genetic diseases, according to Hao Di, the chief judge in the case, who concluded that the insurer failed to make a clear and valid inquiry.

"In essence, the insurer asked about genetic diseases, not family cancer history," Hao said. "With current medical knowledge, it is difficult to classify family cancer history as a genetic disease."

The judge also noted that Huang had informed the insurance agent about her mother's cancer during the application process, but the agent neither asked follow-up questions nor rejected the application.

She said nearly 70 percent of personal insurance disputes involve issues related to disclosure obligations.

"Insurers must ensure their inquiries are reasonable and unambiguous, providing clear explanations for specialized terms rather than using vague or overly broad questions," she said.

"Expecting consumers to disclose information beyond the scope of clearly stated policy inquiries does not align with the principle of utmost good faith expected of insurers," she added. "Such expectations would undermine the protection of financial consumers' rights and hinder the sustainable development of the health insurance industry."