Frankfurt Most people underestimate the risk of becoming disabled. On average, however, one in four will fail at least once for a longer period in the course of their professional life. If there is no earnings, most consumers will lack their main source of income.
Occupational disability insurance, or BU for short, cushions the financial consequences and is therefore considered one of the most important forms of insurance for private individuals – especially during the coronavirus pandemic. Experts expect more benefits, including mental illness and consequential damage from Covid 19 disease.
Potsdam-based specialist broker Frank Dietrich says: “The psychological stress in the corona crisis is increasing. I expect a larger wave of depression, which will be favored by social isolation. As a result, some patients will no longer be able to practice their profession, or only partially. ”
In general, the BU insurance pays a pension if, for health reasons, the insured person can no longer work permanently or only to a certain extent in their own profession. Some policies also apply if there is a long-term ban on work due to the risk of infection.
However, many occupational disability policies also reveal weaknesses in the crisis, especially when it comes to this so-called infection clause. If you are thinking about a new contract, you should consider a few points.
Mental illnesses are increasing. But even before the corona crisis, they were the most common cause of disability. They account for almost a third of insurance claims, as data from the Association of the German Insurance Industry (GDV) shows.
Around a fifth of the cases are related to back or joint problems and osteoarthritis. Accidents are only nine percent responsible for occupational disability.
Often, however, it is difficult to prove mental illnesses to the insurer, complains Dietrich. According to the GDV, only every fifth application for a BU pension is rejected. However, the most common reason for rejection is that the insured person does not reach the agreed level of disability, usually 50 percent.
In the case of unclear cases, it could be advantageous for the insured person not only to submit the existing medical documents, but also to have a medical report drawn up. According to the GDV, 63 percent of all reports lead to a positive benefit decision for the insured. When it comes to the psyche, Dietrich also advises its customers to seek inpatient treatment. Then the case is usually clear.
Disabled due to consequential damage
There could also be more insurance claims in the BU in the future because permanent damage may also remain after a coronavirus infection. According to experts, this could permanently damage the lungs and the heart. It is also being discussed that the virus could trigger meningitis, which could then lead to consequential damage.
According to Dietrich, good policies also pay a BU pension if the insured can still work with these consequential damages. It only has to be less than 50 percent of what he could work on days when he was still healthy.
The Federation of Insured Persons (BdV) also points out that insured persons who work in parallel to receiving a BU pension may also receive short-time work benefits in the current situation. This has no impact on the existing disability pension.
Dietrich considers it important that BU contracts also include a so-called incapacity clause (AU). Because while the occupational disability policy protects the insured if they can no longer practice their profession in the long term, the daily sickness insurance takes over if the customer is temporarily unable to work.
The problem that the daily subsistence insurer could now say that the customer is unable to work and that the occupational disability insurance states that he is unable to work – and thus neither of them wants to pay – can be eliminated by an AU clause, Dietrich explains. Then the customer receives a pension from his BU insurance for a certain period of time, even if no incapacity for work has been determined, but only incapacity to work.
Few policies with infection clause
In connection with the corona crisis, the keyword infection clause repeatedly comes up. If it is included in the contract, the insurer pays a BU pension if there is an official or judicial order stating that the work must not be carried out for at least six months due to the risk of infection.
At the BdV, it is said that there are currently no empirical values known that “permanent employment bans are being imposed because of Covid 19 infections.” Dietrich counters, however: “A few weeks ago we could not imagine the current situation. Who knows what will come despite the planned gradual easing. “
However, he had the experience that only about five percent of the BU contracts contain well-formulated infection clauses. Many policies do not contain such a clause. Some insurers limit benefits to certain professional groups.
Even those who have already been infected with the corona virus can still conclude a BU contract. “A well-cured Covid 19 disease does not in principle stand in the way of taking out occupational disability insurance,” says the industry association GDV.
Consequential damage could become a problem. The ability to insure is sinking because consumers have to state the illness when answering the health questions, according to Dietrich: “If you want to conclude a contract now, the health insurer should give you the listed treatment data and the medical record of the family doctor.” Only if the health questions at the If the application is answered correctly and completely, the consumer has a chance in the event of an insurance that the insurer also pays.
More: How insurance customers can save in the corona crisis