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Employer's Disability insurance


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Hello insurance brains.

 

I'm trying to help a friend who is off sick due to a psychological problem and would appreciate your input.

 

Because of a few breakdowns in communication between the employer and the insurer, he wasn't sent to see a consultant psychiatrist until very recently, when a qualifying diagnosis [in terms of the policy wording] was confirmed.

 

In my view, the Group PDI is now liable from the beginning of the sickness period, or rather from the end of the waiting time, in this case 26 weeks, am I right please? The symptoms have been the same throughout, it's just that his GP [who isn't a psychiatrist after all, and is very supportive] and some other health professionals didn't identify what the exact illness was. Some of them were being paid by the insurer. The insurer wants the illness claimed for to come into the ICD-10 [i hope that's right] definition and it does.

 

Do you think we can argue that payments should be backdated to the beginning of the entitlement period with interest please?

 

My friend and I will be eternally grateful, thank you. If I've left anything out or explained it badly, please let me know.

 

HB :)

 

PS I've forgotten some of the jargon, but if you talk to me in insurance-speak, I'll understand ;). It's 100 years since I sat the ACII exams.

Illegitimi non carborundum

 

 

 

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