Daily sickness allowance from private insurance: enforce the benefit

A daily sickness allowance insurance (private or as an add-on) replaces lost earnings in case of incapacity for work. Disputes often arise over proof of the incapacity or when the insurer wants to switch to an alleged occupational disability. What matters are seamless evidence and the right reaction.

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Your chances of getting your money back

With proven incapacity for work, you have a claim to the agreed daily sickness allowance. The insurer has to pay as long as the requirements are met and you fulfill your duties to cooperate.

If the insurer switches to occupational disability (to end the benefit), tight requirements have to be met for this. A blanket stopping without a sufficient basis is attackable.

What you should do now

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1. Keep seamless evidence
Submit ongoing incapacity certificates and requested documents in time.
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2. Check the terms
Clarify the waiting period, the amount of the allowance and the requirements for stopping the benefit in your contract.
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3. Question a stopping
If the insurer wants to reduce because of alleged occupational disability or recovery, demand a concrete justification.
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4. Demand the benefit
Demand outstanding daily sickness allowance in writing with a deadline and object to an unjustified stopping.

How to spot the scam

Payment is stopped with the blanket reference to 'occupational disability'.
Requested evidence is not clearly named, but then counted as missing.
Pressure is applied to sign a settlement or cancellation proposal.

Frequently asked questions

When does the daily sickness allowance insurance pay?

With proven incapacity for work after the agreed waiting period expires, in the amount of the agreed daily allowance, as long as the requirements are met. You have to fulfill your duties to cooperate, for example submitting ongoing incapacity certificates.

May the insurer stop the payment?

Only under the contractual requirements, for example if fitness for work is restored. A switch to 'occupational disability' to end the benefit has tight requirements. A blanket stopping without a sufficient basis you can attack.

How do I enforce the benefit?

Keep seamless evidence, check your insurance terms and demand outstanding allowance in writing with a deadline. Object to an unjustified stopping and demand a concrete justification. In a dispute, professional support helps.

Take action now

We put together the ready-made texts and the right places to contact for you.

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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.