With document management well tied, the insurance contract law The changes from 2026 onwards will mainly affect how insurers and policyholders document deadlines, communications, and requirements, with more objective and traceable rules.
Law No. 15.040/2024 consolidates principles of good faith and transparency, requires clearer clauses and reduces ambiguities, which tends to decrease rework, interpretative disputes and friction in claims settlement. For the operation, the novelty lies less in the concept of insurance and more in the flow: proposals with defined SLAs, document requests with limits, and always formal and substantiated denials.
Summary
- What changes in proposal deadlines and tacit acceptance triggers.
- How to handle documentation requirements and formal communication with an auditable workflow.
- What changes in the claims SLA: notification, payment, and justified refusal.
- KPIs to monitor rework, rejections, resolution time, and NPS.
- Routine for continuous review of clauses and operational controls in 2026.
Quick facts
- The consolidated text and regulatory history can be found at Federal Senate Legislation page, which organizes references and indicates repeals and validity linked to article 134.
- An excerpt from the legislative debate appears in opinions and documents from the Senateuseful for contextualizing the objective of organizing the microsystem of the insurance contract.
- The institutional summary of the regulatory agency is in the news article. susep, highlighting predictability, transparency and deadlines in claims handling.
Insurance contract law in 2026: why does 2026 become the first "full year" of adaptation?
Law No. 15.040/2024 was published on December 10, 2024, which establishes the effective date stipulated in Article 134 and explains why 2026 focuses on routine adjustments, training, and review of clauses. This temporal anchor appears in Official Gazette...and the law itself indicates the rule for entry into force after 1 year from official publication, as stated in article 134 in the legislative repository of... Câmara dos DeputadosFor legal and operations teams, 2026 is typically the first full cycle in which metrics and SLAs reflect the new discipline.
In practice, this changes the way contracts are audited: more evidence of communication, less room for ambiguity, and more consistency in deadlines. Those who already work with... contract management You tend to feel the effect faster because the gain comes from standardizing texts, controlling versions, and recording interactions at each stage, from proposal acceptance to claims settlement.
What aspects of the legal and operational teams' work are on their radar?
The focus is now on reducing gray areas. Susep emphasizes that coverages, exclusions, and risks must be presented clearly, without ambiguity, and that, in case of differing interpretations, the understanding most favorable to the insured, beneficiary, or injured third party prevails. It also reinforces defined deadlines for handling claims, with the insurer responding within 30 days of notification, within more predictable procedures.
This set of points appears in the institutional statement regarding the law's entry into force. This connects directly to documentation routines, such as decision trails and attachment records, which become simpler when there is an electronic signature with logs and evidence.
What changes in practice through operational flow?
Let's now look at the 5 main changes.
1) Writing highlighted coverage and exclusions
The new framework puts pressure on the revision of clauses: covered risks, excluded risks, and activation conditions need to be described unequivocally and prominently, as well as reinforcing journalistic coverage and sector analyses.
One practical effect is to reduce generic "standard text" and adopt operational language: definition, trigger, required document, and deadline. For teams that already use digital contractTherefore, it makes sense to version templates and tie internal approvals to a change history to prevent old versions from continuing to circulate in sales or renewals.
| Clause item | Common risk | How to "translate" into operation | Recommended evidence |
|---|---|---|---|
| Exclusions | Broad and ambiguous terms | Objective list + application examples | Contract version + registered acceptance |
| Claims conditions | Loose and variable checklist | Standardized checklist by product | Protocol + attachments with tracking information |
| Cancellation | Unilateral cancellation clause | Triggers aligned with legal hypotheses. | Traceable formal communication |
2) Interpretation in favor of the insured when there is doubt.
When there is doubt about the scope of coverage or about contractual terms, the interpretation most favorable to the insured gains normative reinforcement, and this changes the way "dispute zones" are drafted. A simple approach is to create an appendix of definitions (glossary) and maintain a revision history for each product.
In legal practice, this reduces reactive consultations and increases preventive reviews. Tools such as contract review Internal approval processes become more valuable when they leave consistent evidence of what was approved, by whom, and on what date.
3) Proposal deadlines: acceptance, rejection, and silence.
A typical operational change is in the proposal SLA. The industry summary published in market publications highlights the deadline for expressing acceptance or rejection and the risk of silence being interpreted as acceptance, making it mandatory to monitor the queue, pending items, and formal responses.
In terms of process, this calls for a single dashboard of proposals with running time, paused time, and restarted time, as well as a record of each interaction with the client. For the sales workflow, it's worth integrating the acceptance stage with... electronic signature to shorten the hiring process and reduce the risk of proposals being stalled due to lack of client response.
| Stage | Event | operational risk | Recommended control |
|---|---|---|---|
| Entry | Receipt of the proposal | Missed deadline due to a confusing queue. | Protocol + timestamp |
| Requirement | Request for additional information/documents | Batch requirements and rework | Single request + track |
| Output | Formal acceptance or rejection | Refusal without justification | Standardized model + signature |
4) Single request for documents and additional requirements
Part of the public debate surrounding the law highlights that requests for additional information and documents should only be made once, affecting the suspension and resumption of the time count, which changes the behavior of requesting yet another item later. This rule reduces the incentive for successive requests and pushes insurers to standardize checklists by proposal type and risk profile.
In the operation, this becomes a metric: how many proposals required further information, how many were reopened, and for what reason. When document collection happens with electronic document managementThis makes it easier to demonstrate the moment the order was placed and when it was fully received.
5) Claim: notification, deadlines and justified refusal
In the event of a claim, the most impactful aspect of daily operations is the timeframe and formalization process. SUSEP (the Brazilian insurance regulator) emphasizes that the insurer must respond within 30 days of receiving the claim notification, with the possibility of requesting supplementary documents in a justified manner and with limits on the possibility of suspending this timeframe.
In sectoral summaries, there is also the requirement for refusals to be formal and justified. This increases the need for traceable communication: protocol, attachment, justification, and final decision. Here, a signed document is evidence, and practices such as digital signature verifier They assist with internal auditing and answering questions.
Practical example: claim with supplementary documents
Imagine a property damage claim where the initial notification includes a police report, photos, and an invoice, but lacks a technical report. With more controlled requirements, the team needs to request the complete set of documents at once, with clear justification, and register their receipt to restart the analysis period.
When this workflow relies on loose emails and scattered attachments, the chance of rework and delays increases. Conversely, a workflow with... digital documents Centralized protocols and electronic signatures in internal communications reduce discrepancies regarding "when" and "what" was requested.
Check out these related articles as well:
- To standardize hiring evidence, How digital signature works It details operational concepts and validation points.
- To discuss security and evidence, Is a digital signature trustworthy? It organizes technical and legal verification criteria.
- For routines with large volumes, How to sign documents in bulk It helps to design processes with fewer bottlenecks and more control.
Key Performance Indicators (KPIs) to track in 2026
While the law tightens deadlines and transparency, it also facilitates management by indicators. Instead of discussing isolated cases, the legal and operational departments can monitor the overall workflow. Below is a practical basis for KPIs for proposals and claims, focusing on cost, rework, and experience.
For teams looking to reduce costs and accelerate sales, combining these KPIs with automation and contract automation It usually reduces the time between a draft being prepared and a contract being signed.
| KPI | How to measure | Why is it useful? | Warning sign |
|---|---|---|---|
| Response SLA (proposal) | Time between receipt and formal response. | Avoids acceptance by silence and reduces queues. | Increase in outstanding items at the end of the month. |
| Regulation time | Claim notification until decision/payment | It demonstrates efficiency and the risk of non-compliance. | Peaks due to lack of checklist |
| % additional requirements | Claims/claims with additional requests | Indicates input quality and standardization. | Requirements across multiple rounds |
| Negative rate | Negatives / reported claims | It helps to review clauses and communication. | Negatives with recurring challenges |
| Rework | Reopenings due to document, deadline, or failure. | Quantifies operational cost | Reopening due to "document already sent" |
| NPS/CSAT of the claim | Post-outcome research | It relates deadlines and clarity to perception. | Hair loss following procedural changes |
Formal and traceable communication as a proof requirement.
The requirement for formal and justified decisions pushes the organization towards a communication standard that is auditable. This involves two pillars:
- Message with standardized minimum content (event, basis, deadline, attachment);
- Evidence of authorship and integrity (who signed, when, and if there were any alterations).
For this second pillar, concepts such as hash function Timestamps and digital evidence help explain why digital evidence is stronger than a loose PDF in a folder. In internal audits, the goal is simple: to reduce discussion about "version" and "date".
Routine for continuous review of clauses and processes.
By 2026, the best response is not a one-off adaptation project, but rather a routine. The framework alters deadlines and reduces tolerance for ambiguity, so the legal department needs a review cycle with clear triggers: new product, increased disputes, change in sales channel, or concentration of documentary requirements for a single reason.
The same applies to template governance: approve, version, publish, and discontinue. Along these lines, best practices include: conformity Access controls help prevent old templates from continuing to be used out of habit.
A practical summary for insurance contract law in 2026
In 2026, operational gains come from treating the contract as a flow with SLAs, evidence, and communication standards: clearer coverages and exclusions, more predictable interpretation in case of doubt, more controlled documentation requirements, and claims with formally justified deadlines and denials. At the point of sale, this calls for standardization and traceability, reducing rework and disputes over dates, versions, and attachments.
To close the loop with less cost and more speed, the ZapSign's digital signature solution It supports execution and proof, reinforcing the operational logic of insurance contract law.
Frequently Asked Questions (FAQ)
When will Law No. 15.040/2024 begin to affect the routine of insurance companies and policyholders?
The law has a rule of validity linked to official publication, and implementation is usually reflected more strongly in the first full calendar year of operation under the new standards. Even when the entry into force occurs at the end of a year, the following cycle focuses on reviewing clauses, standardizing communication, and adjusting SLAs, because that is when goals, indicators, and audits begin to run from beginning to end within the same regime.
What changes in the insurance proposal and why does the term become a central issue?
The proposal now requires more rigorous time control and formal response, because defined deadlines and the effects of silence can transform a poorly managed queue into a contractual risk. In practice, this calls for screening, an entry checklist, and recording of any additional requirements to avoid back-and-forth movements that suspend and resume the count. The expected result is to reduce uncertainty and make the path between proposal, acceptance, and issuance predictable.
How does the rule of interpretation most favorable to the insured impact the text of the contract?
She is urging the organization to reduce ambiguity and clearly state what is covered and what is excluded, using prominent and operational language. Generic clauses tend to increase the risk of disputes because, in case of doubt, the interpretation may favor the insured. Therefore, it becomes important to maintain a glossary, examples, and a history of versions, as well as aligning the contract text with sales materials and formal communications.
What changes in the claims process in terms of deadlines and communication?
Claims handling tends to become more standardized: deadlines for responding, the possibility of requesting supplementary documents with justification, and the need for formal decisions, including in cases of refusal. Operationally, this requires protocol, notification registration, a trail of attachments, and traceable justifications. Teams that properly document the moment of the request and the moment of complete receipt reduce discussions about suspending and resuming deadlines.
What indicators help prove that the operation became more efficient in 2026?
Practical indicators include proposal response SLAs, total claims settlement time, percentage of additional requirements, denial rate, and volume of rework due to reopening. In parallel, post-claim NPS/CSAT shows perception of clarity and agility. The combined reading of this data helps to separate text problems (confusing clause) from process problems (weak checklist, non-standardized communication, or lack of an auditable trail).
CEO of Henshin Agency and digital marketing consultant, fascinated by content marketing and an admirer of Japanese culture.
