Private Disability

The private disability insurance is a special type of insurance because of the risk it covers: the inability to work.

The term ‘disability’ contains legal as well as medical and employment aspects. The legal aspects mostly concern the (interpretation of the) insurance policy. The medical aspects regard the question whether the disorders experienced by the insured party are medically objectifiable and lead to limitations. The employment aspects become relevant when answering the question whether these limitations lead to the inability of the insured to (fully) perform his professional activities.

The proper handling of a disability insurance case not only requires legal knowledge, but also knowledge of the medical and employment background of the case. The medical advice and the employment experts’ reports are consulted. If necessary, additional questions will be presented to the medical adviser and/or employment expert.

Van Traa regularly advises and litigates in disability insurance cases on behalf of insurance companies. The procedures may be brought before the national courts as well as before the Dutch Financial Services Complaints Institute (KiFiD). This legal practice is diverse and challenging.

The following questions may be the subject of a private disability insurance case: 

• Has the insured party complied with his information requirement when applying for the private disability insurance? If not, does this have any consequences for the insured?
• Whether the insured party has complied with his information requirement when applying for the private disability insurance and if not, does this have any consequences for the insured.
• Does it concern disability in the sense of the insurance policy conditions? And, if so, for which percentage?
• Is incapacity for work within the meaning of the policy conditions of the disability insurance and, if so, for what percentage?
• Does it concern disability in the sense of the insurance policy conditions and if so, for which percentage?
• Has the insured informed the insurer in time and in full about his incapacity for work?
• Has the insured party violated the information requirement by intentionally misleading the insurer?
• Whether the insured party violated the information requirement by intentionally misleading the insurer.
• Is the insurer allowed to terminate the private disability insurance agreement?
• Is there reason to reclaim previous payments under the insurance policy?

In each case, the correct approach to the case will have to be determined in consultation with the insurer.