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What are occupational disability health issues?

In occupational disability insurance (BU), health issues are an important part of the application. Incomplete or untruthful statements may lead to refusal of benefits in the event of disability and further unpleasant consequences for the insured. Disability insurance
Answer health questions correctly.

Before an occupational disability insurance can be taken out, the applicant must first undergo a risk assessment. The insurance company would like to assess the probability that the insured will actually become unfit for work . In addition to the profession, the hobbies and other features, the insurance is particularly interested in the health of the applicant. This is usually raised by very complex and detailed health issues.

Here is a small, exemplary excerpt from Alliance health questions related to the past five years:

Are you or have you consulted, treated, or examined any disease, medical condition or medical condition with doctors, alternative practitioners, physiotherapists, psychotherapists or other non-medical therapists in the following areas:

  • a) Heart, circulation (eg, coronary heart disease, medically diagnosed high blood pressure, stroke, phlebitis)?
  • b) Respiratory organs (eg pneumonia, chronic bronchitis, asthma)?
  • c) Digestive organs (eg stomach, intestine, bile, pancreas, liver)?

Consequences of identified risks in the health examination

 

Resulta ng larawan para sa health examination

If the insurance company identifies risks to the applicant with the health questions answered, it has various options for reacting to them.

  • Refusal : The applicant has no opportunity to be insured against occupational disability with this insurance.
  • Risk premiums : Due to the increased risk of occupational disability, for example due to certain previous illnesses, the insured must also pay higher contributions for his disability insurance.
  • Exclusions: Had an applicant, for example, in the past knee problems, the insurer may offer him a BU policy that excludes a pension payment in the event that he is unable to work due to knee problems.

Responsible handling of disability insurance health issues

Rejection, risk premiums and exclusions by the insurance company are very unpleasant results for the applicant. However, too light a way of dealing with health issues is not a solution: Misrepresentations or the concealment of previous illnesses can lead to the insurer failing to provide occupational disability insurance. In addition, future insurance contracts with other providers are difficult . For occupational disability insurance, therefore, health care must be treated with particular care and attention .

Conserve health history and previous illnesses conscientiously

Before health care issues are addressed for disability insurance, the applicant should thoroughly review his or her own health history. For whether a therapy, a previous illness or an operation was only forgotten or deliberately concealed – consequences may have this misstatement anyway. To be completely sure that he has taken into account all the relevant pre-existing conditions, the applicant should therefore obtain information in advance from his health insurance and his attending physicians .

As a rule, there is a statute of limitations for occupational disability insurance for health issues. Often, illnesses, complaints, and doctor visits are only queried for the past five years, and surgeries and psychotherapies only for the past ten years . The shorter the polling period, the lower the likelihood that the applicant will intentionally or unintentionally violate his or her duty to report in the course of the health check.

Make risk inquiries with different insurers

If the applicant fears being rejected by the insurance based on his or her health history, he / she may have a risk pre-requisition made by an insurance broker . The mediator communicates the critical health information anonymously or under a false name (pseudonymized) to different companies at the same time . If the insured is rejected by a provider on the basis of this information , he or she does not need to fear any further consequences in the course of the risk pre-request, as it can not be personally associated with the incriminating characteristics.

Health questions conscientiously and truthfully answer

If health issues have not been answered in the true sense, there is a breach of duty . The insurance company then has the right, in particular in serious cases, to

  • to withdraw from the contract
  • to withhold the contributions already paid
  • stop the pension payment that may have started.

For example, fraudulent and deliberate misrepresentations in the BU health issues only have a limitation period of up to ten years . If the insurer becomes aware of the misstatements within this period, it may draw consequences. However, applicants should not reveal more than is actually asked . Here it is very important to pay attention to formulations .

The information and information system of the insurance industry

Insurance companies also have the right to save the answers to health questions for each individual in the Insurance Information and Information System (HIS). Among other things, this database contains information about policyholders, insured persons, injured persons and objects as well as witnesses . The purpose of this system is an efficient risk assessment and the fight against insurance fraud , with the aim of protecting the community of insured persons from financial disadvantages.

Each insurance company can thus create data on persons as a precautionary measure or in suspicious cases in this system. Also already known risks and pre-existing conditions are stored here. Here is also an advantage of the anonymous or pseudonymized risk pre-inquiry: An entry in the HIS can not be made by the insurance company, as it has no personal data.

Other insurances that a person applies for have access to this database and can reject new requests based on the information stored . A record can be stored for up to five years. If a new notification is made, this period will be extended to a maximum of ten years . Actual health risks but above all false information can therefore have far-reaching consequences.

Simplified occupational disability insurance Health issues in the application process

Some occupational disability insurances offer simplified health issues when applying. These are fewer and more condensed issues that also affect a shorter period of time . While occupational disability insurance usually covers several pages of health issues, in the simplified form, for example, only three or five questions can be asked, which the applicant must ultimately answer in summary and one-time with a YES or NO.

It should be noted that for the consumer in the BU, the simplified health issues do not always have an advantage . They are often associated with strict conditions, such as a maximum pension amount , a maximum retirement age or the restriction to certain occupational categories . Also, the generalized formulations of simplified health issues may make it difficult for the policyholder to truthfully answer , as he or she may not be reminded of certain milestones in his or her health history.

Rarity: occupational disability insurance without health issues

It is rarely possible to take out occupational disability insurance without health issues and is subject to certain conditions, such as a limited monthly BU pension . For example, the insurance company can waive the BU health issues if the occupational disability insurance is completed as an addition (BUZ) to another insurance , such as a life insurance policy. Some insurers also refrain from health issues if the claimant already has the status of a bonus customer , for example, has already completed a certain number of policies with the company.

In addition, an existing policy may often be retrospectively adjusted for health issues without re-occupational disability insurance if automatic dynamics have been agreed or if the post-insurance guarantee is used.