Daily sickness benefit refused
Is your daily sickness benefit insurance not paying out? Your rights in Augsburg
Private daily sickness benefit insurance is designed to cover your loss of earnings if you are unable to work. However, insurers are increasingly refusing, reducing or delaying payments – whether by disputing your inability to work, accusing you of providing false information, or terminating the contract prematurely. As specialist insurance lawyers in Augsburg, we will ensure you receive your daily sickness benefit despite uncooperative insurers.
Why daily sickness benefit insurance doesn’t pay out – common reasons for rejection
Daily sickness benefit insurance under Section 192(5) of the Insurance Contract Act (VVG) is intended to compensate for loss of earnings resulting from incapacity to work due to illness or accident. Insurers employ various strategies to refuse or reduce payments. In Augsburg, we regularly encounter cases where the refusal is legally untenable.
Cancellation and termination of the contract – when the insurer is entitled to terminate the contract
A particular risk with daily sickness benefit insurance: the insurer may attempt to terminate the policy whilst you are unable to work, or to have it lapse by claiming that you are permanently unable to work. In Augsburg, we challenge unlawful terminations and safeguard your entitlement to benefits.
Tell us about your situation - without obligation and nationwide.
Daily Sickness Benefit Check
Check your situation if your daily sickness benefit insurance is not paying out.
This is how we secure your sick pay in Augsburg
Securing daily sickness benefits requires specialist knowledge at the intersection of insurance, employment and social security law. Our team in Augsburg is familiar with insurers’ tactics and knows which arguments carry weight in court.
Medical evidence and expert reports
The key to a successful claim is providing evidence of your inability to work. We work with medical experts to document your limitations in an objective manner. In doing so, we ensure that the certificates of incapacity for work issued by your treating doctors meet the requirements of insurance law – as formal errors give the insurer unnecessary grounds for challenge.
Interim relief in cases of urgent need
Sickness benefit is often your only source of income whilst you are unable to work. If the insurer stops paying, you can quickly find yourself in financial difficulty. In urgent cases, we apply for interim relief at the Augsburg Regional Court to ensure that payments continue for the time being whilst the main proceedings are ongoing.
Pitfalls of daily sickness benefit – avoiding common mistakes
Daily sickness benefit insurance has its own pitfalls, which differ from those of occupational disability insurance. Here in Augsburg, we can advise you on how to safeguard your entitlement from the outset and avoid the typical mistakes that insurers use as grounds for rejecting claims.
A continuous certificate of incapacity for work
One of the most common pitfalls: the sick note is not renewed without a gap. Even a single day without a valid sick note can result in the insurer suspending payments and requiring you to submit a new claim. Make sure your doctor renews the sick note seamlessly – ideally on the last day of its validity or before.
Be careful with secondary employment and social media
Insurers are increasingly hiring private investigators and monitoring social media to document activities that contradict claims of incapacity for work. Even harmless photos of a walk or a holiday can be used against you. This does not mean you have to lock yourself away – but your activities should be consistent with the medical condition certified by your doctor. Discuss any cases where you are in doubt with your solicitor in Augsburg.
Frequently Asked Questions
Further information
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This information does not constitute legal advice in individual cases.
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