Making an income protection insurance claim

To make an income protection insurance claim you must fill in a claim form and send it to your insurance company. The insurance company will need medical proof from your doctor, and may also ask you to have an independent medical examination. If your claim is approved, you will get your first payment after the deferred period is over, if you are still not able to work at that time. If you have returned to work, you will not receive any benefit.

Could your insurer refuse your claim?

Your insurance company may refuse your claim in certain situations, for example, if a claim is caused directly or indirectly by:

  • War, riot, revolution or a similar event
  • You taking part in a criminal act
  • Drug or alcohol abuse
  • Other self-inflicted causes.

These are called exclusions. It is important that you know these exclusions before you take out a policy. You would also not usually be covered if:

  • You did not follow medical advice
  • Your disability was caused by a dangerous hobby, such as hang-gliding or parachuting 
  • You changed jobs and didn't tell the insurance company
  • You moved abroad and didn't tell the insurance company
  • You did not tell your insurance company about a pre-existing condition or you lied about your medical history

If you have an individual policy, there may also be other specific exclusions. For example, your policy might exclude claims for a back injury if you had a previous history of back pain.

The Central Bank’s Consumer Protection Code requires firms to explain certain information to you before you sign up to an income protection insurance policy. They must explain:

  • Their meaning of disability
  • The benefits available under the policy
  • The reductions that may be made to the benefit payments where there are payments from other sources, such as sick pay or social welfare
  • The general exclusions that apply to the policy.

They must also tell you that your cover or any claim you make could be affected if you give incorrect or incomplete information when applying for insurance. 

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