Declined Income Protection claims
How does income protection insurance work?
Many people take out income protection insurance to protect them if they need to take time away from work in the event of an accident or illness.
You may have arranged an income protection policy yourself through an insurance company, or it may be an additional benefit that you have through work.
Income protection insurance is designed to pay a regular income, to replace your lost earnings until you are well enough to return to work, you reach your planned retirement age, or the maximum term described in your policy documents (whichever comes first).
The amount you receive with this type of insurance will be explained in your policy terms and conditions. There is also likely to be a deduction made for any other income you are receiving at the same time, such as state benefits.
It’s worth knowing that there is usually a waiting period before payments start (known as a deferred period). Your policy documents will describe what types of ‘illness’ your insurance policy will cover.
How do I make a claim on a declined income protection policy?
Let Appeal Avenue handle the claim process for you
Suffering from an accident or illness which stops you from being able to work can be a very stressful time; your mind may be overloaded with worries about money and what the future looks like, as well as juggling the symptoms and effects of your illness or health condition. Starting an income protection claim may be the last thing on your mind.
In our experience, thankfully, most insurers are set up to make the insurance claims process as simple and as stress free as possible, but if you still need a helping, friendly hand, this is something we can help you with- make an appointment with us today for us to support you through it.
Or, make your own income protection policy claim following our guide below
1. Make an income protection claim as soon as possible.
Most insurers specify that you must make a claim within certain timeframes after you suffer from an accident or illness that prevents you from being able to work, even if you have a long waiting or deferred period. So, it’s important to contact your insurer and get the ball rolling with a claim as soon as possible.
2. Contact your insurance company.
To make it easier to make a claim, insurers often allow you to start your claim by email, over the phone, by post or even online.
3. Contact your insurance company.
To make it easier to make a claim, insurers often allow you to start your claim by email, over the phone, by post or even online.
4. Provide some basic information.
When you first contact your insurer, be prepared to provide some basic information about your accident or illness. Such as the accident or illness you are suffering from and when you were first absent from work.
5. Complete an income protection claim form.
After your initial contact, the insurer will usually send you an income protection claim form to complete and return. This form will ask for more information about your diagnosis or accident such as when you first started experiencing symptoms of your illness, or when your accident happened. They will also want to know about any tests and investigations you’ve had and the names and addresses of your GP and hospital specialists. Alongside details about your employment, including the job you do and your main duties at work. They will also want to see a copy of your fit note.
6. Wait
This can be the most frustrating part of the process- the time between submitting your income protection claim and hearing back from the insurer can take a number of weeks.
In this time, the insurer will be writing out to your doctors and getting more information about your illness as well as reviewing information about the work you do. They might also be looking into the answers you gave to the health and lifestyle questions you were asked when you initially took out your insurance policy.
7. Decision made by the insurer.
When the insurer has all of the information back from your doctors and they’ve reviewed it against your policy terms and conditions, they will make a decision on whether or not to pay your claim.
If the claim is successful, they will contact you and let you know when to expect your payments, as well as explain how they will be regularly reviewing your claim as time goes on.
If the insurer declines your income protection claim, they should tell you why they have declined it. If your income protection claim is declined, make an appointment with us to talk through what your options might be. If we think you have grounds to appeal the insurers decision, we may be able to complain on your behalf- take a look at the fees section of our website for an idea of the costs involved.
If your income protection claim is declined
Thankfully, every year, thousands of income protection claims are successfully paid out by insurers, but unfortunately, lots of claims are declined.
Insurers refuse to pay out on income protection claims for many reasons- they may not pay out because your medical condition doesn’t meet their requirements or they may feel that you are fit to work, even if your doctors disagree. Other times insurers might decline your insurance claim because they say you didn’t tell them something about your health or lifestyle when you took the policy out- this is referred to as non-disclosure or misrepresentation; you can find out more about this on our non-disclosure and misrepresentation page.
The insurer should tell you the reason they have declined to pay out on your income protection claim. If you don’t agree with their decision, you can make a complaint or appeal; visit our ‘tips on making a complaint or appeal’ page for more information.
If you would like our support with making a complaint or appeal, make an appointment with us today and we will chat through what has happened and what your options are – take a look at the fees section of our website for an idea of the costs involved.
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