income protection claim while off sick with depression
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My employer's insurer has concluded that they don't have enough evidence that I am not fit for work despite the fact that both my GP and the Occupational Health doctor say so. Is this common and why? They want me to see their own consultant. Thanks
bibiSmith
1 year ago
Expert Financial Adviser Answer
James Brooke
answered 1 year ago
Yes, this is quite normal practice, especially at the start of a claim. It may be for a number of reasons. The most common is to do with the wording of the Income Protection policy. There are basically three definitions that are used.
Own occupation
Own or suited occupation
Any occupation.
It sounds as though the insurer is not convinced that you illness meets the definition of incapacity that the policy is based on.
Obviously 'own occupation' is the best definition because the policy will pay out if you are unable to carry out your own occupation.
The next best is 'own or suited' and it may be that the insurer is trying to confirm that you are not able to carry out any occupation for which you are suited.
The worst definition is 'any occupation' because you need to be really ill to be unable to carry out 'any occupation'.
Lastly it is in no one's interests to have you return to work too soon only to relapse as the insurer will them face paying the claim for longer and the doctor will have a patient who has relapsed and you will obvioulsy have gone backwards and thus are likely to take even longer to make a full recovery.
We wish you the best of luck and a speedy recovery.
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Own occupation
Own or suited occupation
Any occupation.
It sounds as though the insurer is not convinced that you illness meets the definition of incapacity that the policy is based on.
Obviously 'own occupation' is the best definition because the policy will pay out if you are unable to carry out your own occupation.
The next best is 'own or suited' and it may be that the insurer is trying to confirm that you are not able to carry out any occupation for which you are suited.
The worst definition is 'any occupation' because you need to be really ill to be unable to carry out 'any occupation'.
Lastly it is in no one's interests to have you return to work too soon only to relapse as the insurer will them face paying the claim for longer and the doctor will have a patient who has relapsed and you will obvioulsy have gone backwards and thus are likely to take even longer to make a full recovery.
We wish you the best of luck and a speedy recovery.