Incapable of working due to Covid: does the insurance pay?

The pandemic affects many areas of life. Insurance companies are also affected: What if you become unable to work due to Covid-19?

The coronavirus and its consequences have made many people aware of how vulnerable they are. "This pandemic makes you realize how fast it can go," confirms Peter Grieble, insurance expert at the Baden-Württemberg consumer center. "For some, this is an occasion to reflect on the importance of occupational disability insurance for themselves."

But to what extent does this insurance apply in the event of corona disease and its possible long-term consequences? After all, Covid-19 has turned the world upside down as a new disease. There has never been a lot like this - so the right regulations have to be found first. Important questions and answers:

What kind of case does an occupational disability insurance cover?

This insurance, called BU for short, is ultimately about securing a livelihood. "If, due to illness, an accident or a loss of strength, for health reasons, I can no longer work at least 50 percent of the time, I will receive the agreed monthly pension," explains Grieble. “It is supposed to replace the income that is now lost.” As a rule, the BU takes effect when someone cannot work in his or her profession for at least six months.

Does the BU also pay for long-term corona consequences?

Basically yes: Anyone who has a BU and is unable to work due to Long-Covid receives the agreed service. "The cause of an occupational disability is not decisive," says Christian Bökenheide, BU expert at the German Insurance Association (GDV). "Whether it is Covid-19, another serious illness or physical wear and tear - the decisive factor is that the restrictions mean that you are no longer able to do your job for at least 50 percent."

If the insured person submits a claim for benefits, regardless of the cause, a benefit test is carried out. Depending on the impairment, it also depends on the medical prognosis: Can a condition improve, for example through rehab? For Covid-19, however, there is hardly any empirical data after a good year.

"At the moment, no general statements are possible," says Bökenheide. Consumer advocate Grieble explains: “So far we have not had a case in which consumers have turned to us who did not receive their BU service because of Corona.” Incidentally, a BU also applies to vaccination damage - currently also a topic that concerns many.

What applies if I am acutely ill with Corona and want a BU?

In that case, probably no insurer would give immediate insurance cover. “It's like other illnesses that I have acute,” says Grieble. "Either the insurer will postpone the application for a certain period of time or want to exclude the specific risk with its consequential damage at least temporarily."

"Many companies then say: We are not yet concluding a contract, but will postpone the application until the acute phase is over," confirms GDV expert Bökenheide. "Then we see what the health situation is like."

What applies to graduation after recovering from illness?

A health examination is always carried out before completing a BU. "The current state of health is considered and assessed as a whole, which risk arises from it" explains Bökenheide. "A mild corona disease without consequences should have less of an impact on the risk than a severe course with lasting consequences."

At the end there is an offer from the insurer. "Possibly with a surcharge or an exclusion," says the GDV specialist. "Depending on how severe the consequences are, it may also be that a contract cannot be concluded because the risk is too high."

What if you don't ask about a Covid infection?

One thing is clear: a known Covid infection must not be concealed in the insurance application. "In general, the following applies to the health questionnaires: What is asked for must also be stated, otherwise there is a risk that no benefits can be granted in the end," warns Bökenheide. To what extent there will be a specific Corona question in the future, he is unable to say, every company has its own questionnaires.

Even if Corona is not explicitly asked for, it extends into many areas, emphasizes Peter Grieble. “In general, insurers also ask about respiratory diseases in recent years. And if Covid-19 has expressed itself to me in gastrointestinal problems, I must also state these complaints with the corresponding question. "

Is the so-called infection clause important for Corona?

No, not really. It is about people who are no longer allowed to work because of an infection because they could infect others. “Doctors in particular are treated on an equal footing with this clause,” explains Bökenheide. Here, too, a six-month period usually applies, that is, if there is a ban on the profession for at least six months. As a rule, this should not be the case with Covid-19.

What should you watch out for when completing a BU now?

"If you are thinking about a BU, you shouldn't wait because of the pandemic," advises Peter Grieble. Anyone who has not yet been infected should not expect any problems with Corona at the end of the course. If you have already had a corona infection, you should consider possible differences in the application questions of different insurers.

"That way I can possibly avoid that the application is put on hold," says the consumer advocate.“Depending on the provider, I might get the contract earlier.” He generally recommends contacting a fee-based insurance advisor or specialist insurance broker when concluding a BU.