Health policies, tumour reappearance excludes further compensation to the patient

The relapse of an already indemnified oncological illness does not entitle the holder to further indemnity, as it is the continuation of the same event and not a new pathology. This was established by the Court of Cassation (ordinance no. 807 of 15 January 2026) that confirmed the sentence of the Court of Appeal of Venice no. 2511 of 2022.

She had obtained insurance compensation of 30 thousand euros for the removal of a breast neoplasm (infiltrating ductal carcinoma). Upon the reappearance of the oncological pathology, which occurred four years after the surgery, she had asked for a further indemnity of EUR 140,000 corresponding to 70% permanent disability as recognised by the medical examiner. The insurance company had refused payment, stating that the insurance contract excluded "the possibility of reiterating the assessment of a pathology that had already been the subject of a previous assessment". This was accepted by the Court of Appeal of Venice.

She had argued that the Court of Appeal had uncritically adhered to the conclusions of the court-appointed expert witness, without taking into account the party's expert's report. Arguments that missed the mark. The Court of Cassation agreed with the decision of the territorial court ("Once compensation for an illness has been paid, any aggravation or reoccurrence of the same pathology does not justify further payment"), pointing out that

- the OTC had found that 'from a probabilistic point of view [it is] more plausible that the disease diagnosed in 2015 was a recurrence of the neoplasm that had manifested itself in 2011';

- the party's expert witness had limited himself to arguing that the disease was more aggressive than the previously diagnosed one, a characteristic which, in his opinion, would allow the disease to be qualified as a 'new event for insurance purposes'.