BU application rejected
Has your BU claim been rejected? Here’s how to successfully appeal the decision
Your application for an occupational disability pension has been rejected – but that doesn’t have to be the end of the matter. Around 51% of all rejections are based on the insurer setting the degree of occupational disability at below 50%, with a further 12% based on alleged misrepresentations made when the policy was taken out. The success rate when challenging the decision through legal action is 60–80%. As specialist solicitors in insurance law in Augsburg, we know how to secure your occupational disability pension.
Why applications for occupational disability insurance are rejected – the most common reasons
A claim rejection by an occupational disability insurer usually follows one of three patterns: the insurer disputes the required degree of occupational disability, cites breaches of pre-contractual disclosure obligations, or points to formal errors in the application. In Augsburg, we regularly see cases where, upon closer examination, the rejection does not stand up to scrutiny. Experience shows that insurers tend to reject claims once too often rather than not enough – because many policyholders accept the decision without checking it.
Your rights following a claim rejection – deadlines, options, strategy
If your application for occupational disability insurance has been rejected, you have several options available to you: lodging an appeal with the insurer, seeking mediation through the Insurance Ombudsman, or bringing a claim before the Regional Court. It is important that you do not allow the three-year limitation period (Section 195 of the German Civil Code) to lapse. This period begins at the end of the year in which you received the rejection. In Augsburg, we advise you on which course of action offers the best prospects of success in your case – and support you from the initial assessment right through to enforcement.
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This is how we are tackling opposition to the BU in Augsburg
Challenging a refusal of occupational disability cover requires a systematic strategy. We carry out a comprehensive analysis of your case – from the insurance policy and the medical questionnaire right through to the specific grounds for refusal – and develop the best course of action. In Augsburg and before the Augsburg Regional Court, we have extensive experience in occupational disability disputes against all major insurers.
Analysis and well-founded objection
As a first step, we analyse the rejection letter for legal weaknesses. We check whether the grounds given meet the contractual requirements, whether the insurer has fulfilled its duty of care, and whether the medical assessment is reasonable. On this basis, we draft a well-founded appeal that identifies the specific errors and is supported by medical opinions and a precise description of the claimant’s work.
A lawsuit with a high success rate
If the insurer does not settle, we will take legal action to enforce your claim. The statistics are in your favour: 64% of all occupational disability claims end in a settlement, with a further 10% or so being decided in favour of the insured. Overall, claimants represented by a solicitor receive a payout in 60–80% of cases. During proceedings, the court orders an independent expert opinion, which often corrects the assessment made by the insurer’s expert.
Common mistakes after a work disability insurance claim has been rejected – and how to avoid them
The period following a rejection of an occupational disability claim is critical. Incorrect actions can permanently weaken your position or jeopardise your claims. In Augsburg, we regularly see policyholders undermining their strong initial position through avoidable mistakes. With legal support, you can protect your rights from the very start.
Silence or hasty acceptance
The biggest mistake is to accept the rejection without protest. Around 38% of all rejected claims fail because the insured simply do not respond – neither to follow-up enquiries nor to the rejection itself. At the same time, you should not rush into agreeing to a settlement: some insurers offer a small one-off payment following a rejection, which amounts to only a fraction of what you are actually entitled to.
Incomplete or contradictory information in the appeal
A contradiction that gives the insurer new grounds for challenge does more harm than good. Avoid making sweeping statements such as “I can’t work at all anymore” without medical evidence. Ensure that the information you provide to the insurer, doctors and, where applicable, the pension insurance provider is consistent. Discrepancies between the occupational disability claim and rehabilitation reports are a common point of contention for insurers.
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This information does not constitute legal advice in individual cases.
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