Questão jurídica principal
Whether the insurer could require the insured to apply for disability insurance benefits and offset a hypothetical AI pension under the sickness daily allowance policy.
Decisão extraída
No duty to mitigate under Art. 61 LCA can be used to force a claim against another insurer; however, the policy made benefits subsidiary to actually received AI benefits, and the insured acted against good faith by refusing without reason to apply, so the insurer could offset the hypothetical AI pension.
Fundamentação extraída
Claiming benefits from a third insurer does not reduce the loss within Art. 61 LCA; the issue is instead one of contractual cumulation and suspension/condition. Because the CGA made the daily allowance subsidiary to AI and the insured blocked the condition by refusing to apply without a protected reason, the insurer could treat the condition as fulfilled under good faith principles.