In the given case, the principal dispute had as object two loan contracts signed by Mr. Van Hove. At the time of concluding those loan contracts, he also signed a ‘group insurance contract’ with CNP Assurances, through which CNP Assurances guarantees to cover all loan repayments ‘due from the borrowers to the contracting party in the event of death, permanent and absolute invalidity or 75% of such loan repayments in the event of total incapacity for work’. Also, under the second clause of that contract, the insured person shall be regarded as being in a state of total incapacity for work if, after 90 consecutive days’ interruption of activity following an accident or illness (“the waiting period”), he finds himself unable to take up any activity, paid or otherwise’.
Dl. Van Hove entered into permanent partial incapacity, set by the social security authorities at a percentage of 72%. For the purposes of assessing the cover payable by CNP Assurances, the doctor appointed by that company examined Mr. Van Hove, concluding that his state of health allowed him to carry on appropriate employment on a part-time basis and that they will longer cover his loan repayments, because, while his state of health was no longer compatible with him returning to his former post, he was fit to carry on appropriate employment, at least on a part-time basis.
Mr. Van Hove requested the Court to declare that the terms of the contract between him and CNP Assurances relating to the definition of ‘total incapacity for work’ and the conditions under which cover for that incapacity is acquired are unfair, and to order the defendant in the main proceedings to cover the sums which are still outstanding in connection with the two loans referred to above with effect from June 2012.
By its question, the referring court asks, in essence, whether Article 4(2) of Directive 93/13 must be interpreted as meaning that a term of an insurance contract intended to ensure that loan repayments payable to the lender will be covered in the event of the borrower’s total incapacity for work, will, if that term prevents the insured person from receiving that cover in the event that he is declared fit to carry on an activity, paid or otherwise, fall within the exception set out in that provision.