Unable to work as a result of illness or an accident
Unable to work as a result of illness or an accident?
Make sure you have a source of supplementary income and use your
Guaranteed Income insurance
Notify us if you become unable to work
Provide your insurance agent with the following documents or send
them by post to KBC Insurance, Guaranteed Income Department, f.a.o. the
consulting physician, Professor Roger Van Overstraetenplein 2, 3000
Any medical reports,
documentation relating to check-ups, examinations and any hospital
Note that medical costs are not reimbursed.
Decision regarding your file
We will open a file after receiving the claim form. Your file
administrator will send you written confirmation, along with the
decision of our consulting physician.
1. Your work disability has been accepted
What do you have to do?
Keep us notified at all times of the status of your disorder.
If you need to extend your work disability send us an extension certificate filled in by your doctor,
together with the requisite medical reports that were recently drawn
If you are going to partially resume work send us an
extension certificate filled in by your doctor, together with the
requisite medical reports that were recently drawn up
If you are going to fully resume work send us a personal declaration
What will KBC do for you?
Once the deferment period ends, you will receive the insured annuity
at the end of each month for as long as KBC accepts you are unable to work.
2. Additional information is required for your work disability
What do you have to do ...
... if you have received a request for additional information?
The additional information we require will be set out in your
Consult your family doctor to get medical
If there has been an accident, we sometimes ask
you to provide information about it or to send us a copy of the
official police report
... if you have received an invitation to be examined by the
Sometimes an examination of this kind is required to arrive at
the right decision
If the proposed examination date does
not suit, contact the doctor in question and arrange a new
KBC will pay the medical expenses involved
What will KBC do for you?
We will take a decision regarding your work disability based on the
additional information you provide.
3. Your work disability has been rejected
Disagree with the decision taken by KBC Insurance?
Contact your file administrator or intermediary
us a report from your attending doctor clarifying why you are unable
If there is still no agreement, you can initiate a
joint medical assessment or start legal proceedings
When can I claim on my guaranteed income insurance?
Depending on the formula you chose in your insurance policy, you
receive benefits as soon as you suffer a loss of income for a longer
period (determined in the deferment period) through
An illness, an accident in the private sphere, a work-related
accident or an accident while commuting to or from work (Formula
An illness or an accident in the private sphere (Formula
An illness (older contracts)
For how long am I entitled to receive benefits when I am unable to work?
You will receive benefits for as long as your work disability amounts
to more that 25%, and this up to the expiry date specified when the
contract was entered into.
You will lose the right to
If you die
When you no longer officially reside in
As of the first premium due date for which the
premium was not paid
When your policy ends (for instance,
upon retirement or early retirement)
Which causes of work disability are not covered by my insurance contract?
The following is an overview of the most frequently occurring
exclusions (see your contract for the full, exhaustive list)
Previously existing condition
Intent on the part of the insured person
resulting from excessive consumption of alcohol or drugs
Accidents occurring in a state of drunkenness or under the
influence of drugs
Subjective disorders without objective
Psychological disorders (see your contract for an
exhaustive list of psychological disorders that are covered)
War and riots
Perpetration of violent acts against a
person or persons
Accidents occurring when unreasonable
risks are taken
Nuclear reactions, radioactivity and
ionising rays, except for radiation treatment required for medical
reasons after an insured illness or accident
There are a number of risks that are only covered when explicitly
stated in your contract
Which benefits am I entitled to receive when I am unable to work?
If your degree of work disability is 25% or more, you get
A monthly annuity
A reimbursement of the premium you
paid during the period you were unable to work
How is the insured annuity determined?
At the time you take out your guaranteed income insurance, you also
have to specify an annual annuity. When you are incapacitated for
work, you receive 1/12 of this annuity per month once the deferment
If your work disability period does not
start on the first day or end on the last day of a month, you will
receive benefit payments for this period that are commensurate with
the number of days you were unable to work.
your degree of work disability, the higher the annuity you
If your degree of work disability is less than 25%, you do not
receive any benefits
If your degree of work disability is
between 25% and 66% inclusive, you receive a benefit commensurate
with that degree of work disability
If your degree of work
disability is greater than 66%, you receive the entire insured
Am I covered for my specific profession?
Under certain conditions, you are covered for your specific
profession only in the first year that you are incapacitated for
For longer periods of work disability, we examine
which possibilities are open to you for returning to the labour market
based on your disorder.
I took out a contract with a bought determent period
You are entitled in certain cases to benefit payments from the first
day you are unable to work.
Does my policy also cover incidences of work disability abroad?
Your policy applies worldwide. To qualify for benefits, however, you
must officially reside in Belgium.
What happens if I resume work and a short time later I become incapacitated for work again?
In the event of relapse, the deferment period is not restarted. A
relapse is when
a new degree of work disability occurs within the three months
following the end of an insured period of work disability
the new work disability is attributable to the same
If your new work disability does not meet these conditions, we will
open a new file on your behalf and your deferment period starts again.
Detailed information on how the procedure for a joint medical assessment works
If the insured person's doctor and KBC Insurance's consulting doctor
continue to disagree about the degree and/or duration of the work
disability, a third, independent doctor can be appointed to rule on
KBC Insurance will only propose doctors who
are qualified to conduct the joint medical assessment. The insured
person may make a counter-proposal, but the proposed doctors will need
to possess the requisite competences.
After approval of
the assignment has been received, an agreement to appoint a third
doctor will be drawn up and sent in triplicate to the insured person
for signing. The independent doctor starts the procedure, sends an
invitation to the various parties and draws up a preliminary report.
Both the insured person's doctor and KBC Insurance's doctor may add
further comments, after which the final report is drawn up.
The decisions set out in the final report are binding for both
parties. Therefore – depending on the decisions – an additional
payment may be made, but it is also possible that an amount can be
claimed back from the insured person.
The fees and any
additional costs of the third doctor will be borne jointly by the
insured person and KBC Insurance, each paying half. The costs depend on
the fees charged by the third, independent doctor and whether or not
additional examinations are required.
The moments in your life when you do not exercise a profession or
cannot invoke the Workers' Compensation Act.
Previously existing condition
A disorder or complaint that already existed at the time you took out
De periode die je bij een arbeidsongeschiktheid zelf financieel moet
overbruggen. Deze periode is vastgelegd in je contract en The period
that you have to provide for yourself financially if you become unable
A situation where the same disorder renders you unable to work again
(degree of work disability of at least 25%) within three months of
your previous file being closed.
The sum you wish to receive annually if you become incapacitated for
work. You decide on this amount when you take out your contract.
Besides the amount of the annual annuity, you can also specify how
this amount changes over time.
Degree of work disability
The degree of work disability is a percentage indicating the extent
to which you would be either totally or partially unable to perform
work. The degree of work disability is determined according to
The capacity of the insured person to adapt to another
The knowledge and skills of the insured
Economic disability or work disability
Economic disability or work disability is the reduction in the
capacity to exercise a profession as a consequence of impaired
physical or psychological integrity. This is determined based on
Physiological disability or physical disability
Physiological disability or physical disability cover is usually
provided as a supplement to work disability cover. This cover ensures
that you (also) receive a benefit when there is a diminution of bodily
soundness. No account is taken of your capacity to exercise your
The degree of physical disability is
established by medical decision and is based on the official Belgian
disability scale (Officiële Belgische Schaal ter bepaling van de
Graad van Invaliditeit).
Total/partial work disability
Compensation is paid for both total and partial work
Degree of work disability
Compensation provided by KBC Insurance
less than 25%
no benefit is paid
25% - 66%
benefit is proportional to the degree of work disability
67% or higher
full insured annual annuity is paid (considered as total work disability)
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