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Occupational disability pension denied? How to defend yourself

You can no longer work in your job for health reasons, but the occupational disability insurance does not pay? Refusals are common and often open to challenge. Do not be discouraged by a first rejection.

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Your chances of getting your money back

Decisive is whether you can no longer perform your most recently practiced occupation by at least 50%. Many refusals are based on an overly strict or incorrect assessment; with medical findings this can be challenged.
Common grounds for refusal: an alleged 'pre-contractual breach of the duty to disclose', an abstract/concrete reference to another occupation, or doubts about the degree of the limitation. These points are often legally open to challenge.

What you should do now

  1. 1

    1. Request the refusal and the expert report

    Demand the detailed reasoning and the underlying expert report; check whether it accurately captures your occupation and your limitations.

  2. 2

    2. Collect findings

    Compile current medical reports that prove the extent of the occupational disability, and describe your specific work routine.

  3. 3

    3. Object

    Object to the refusal in writing, factually and with evidence. Observe any deadlines in the insurance terms.

  4. 4

    4. Get legal advice

    Occupational disability cases are complex. Specialized advice (legal protection/legal aid if applicable) significantly increases the chances.

Frequently asked questions

When am I occupationally disabled within the meaning of the insurance?

As a rule, when for health reasons you can probably permanently no longer perform your most recently and specifically practiced occupation by at least 50%. Which occupation is used as a basis and whether a 'reference' is permitted follows from your insurance terms.

Is it worth objecting to the refusal?

Often yes. Many refusals are based on disputed expert reports, an impermissible reference or alleged breaches of the duty to disclose. With meaningful medical findings and, given the complexity, a lawyer's help, decisions can often be corrected.

Take action now

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General information for self-help, not legal advice (RDG). In case of a high loss or uncertainty: contact a consumer advice center or a lawyer.