Four out of five applications for benefits approved

A current evaluation by Franke and Bornberg shows that the insurers examined approve payment of disability insurance in most cases. The amount of the insured pension does not influence the recognition rate.

Stressed worker in the officeWorker stressed at work: In four out of five cases, insurers approve the request for payment of a disability benefit.

Insurers approved four out of five applications for disability insurance benefits in 2021. This is the result of the current study of BU performance practices carried out by the analysis company Franke and Bornberg (F&B), for which ten companies were examined with 7.76 million contracts and a market coverage of around 60 percent.

According to the F&B evaluation, the acceptance rate depends on the respective diagnosis. In the case of cancer, it is the highest at almost 95 percent. The rate is also quite high for diseases of the circulatory system (83.2 percent) and diseases of the nervous system (82.5 percent). In the often complex cases of mental illness, on the other hand, the recognition rate is only 69.6 percent; almost one in three applications is rejected here.

The amount of the insured pension, on the other hand, hardly matters: for all the monthly pensions examined between 300 and 3,300 euros, the rate of recognition exceeded 70 percent, often even exceeding 75 percent.

The rejection rate among young adults is significantly higher. Above all, violations of the pre-contractual duty of notification play a role here, for example previous illnesses that were not specified in the application. Nearly half of such denials concern younger policyholders up to 35 years of age.

Differences in the causes of BI between men and women

Regarding the causes that lead to disability, the F&B analysts identified significant differences between the sexes. Mental illnesses lead to BI in 35.9 percent of women, compared to just 25.6 percent of men. Cancer is also significantly more common in women (25 percent) than in men (15.7 percent).

On the other hand, diseases of the circulatory, muscular and skeletal system and accidents are more common among men. Analysts suspected this could be due to the fact that men work more often in physically demanding jobs and are more willing to take risks than women.

To process the applications, insurers took an average of 159 days for approval and 191 days for rejection. However, these are only average values, emphasized F&B. Many cases would be decided in 100 days.

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