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Insurance exclusions and limitations
Typical Income Protection Insurance Exclusions and Limitations

Don’t make the mistake of thinking that taking out an income protection product means that you will automatically be approved if you need to make a claim. In some cases, you may not qualify for coverage if your situation is seen as being an income protection insurance exclusion. Permanent health insurance exclusions and insurance exclusions and limitations are instances where you will not qualify to make a claim; they are the terms and conditions which an insurer uses to decide whether you can have a payout or not.

So, it is important to check through each and every income protection insurance exclusion before you sign up to any plan to make sure that the permanent health insurance exclusions of your policy are as fair as possible. Let’s take a look at some common exclusions.

When won’t my claim be approved?

Each insurer may have different exclusions of its own, but certain core exclusions are common to most policies. For example, the majority of policies will have a qualifying period in which you will not be able to make a claim.  So, if you wanted to claim your benefits during this qualifying period then you wouldn’t actually qualify!

Given that your policy may cover you for both illness/injury and redundancy/loss of job, let’s take a look at both eventualities to see other cases when your coverage may not apply, and income protection insurance exclusions and limitations will.

Illness/injury

  • You are unlikely to get coverage for pre-existing medical conditions that lead to you not being able to work for long periods. You do also need to declare any of these conditions to the insurer when taking out your policy. In some cases the insurer will cover you, but will only pay out on a claim if you can show that you have had no problems with the conditions for a specific period of time before it flared up again. You may also fall under an income protection insurance exclusion if the insurer can prove that you might have known about a medical problem that could be an issue.

  • If you cannot work due to an illness or injury that is self-inflicted (i.e. like a suicide attempt) then you are not likely to get any benefits from your policy.

  • Some minor medical conditions such as backache are unlikely to be covered by this kind of policy unless they are linked to or actually are a specific medical condition in their own right.

Redundancy/loss of job

  • Most policies will insist that you have been in continuous employment for a specific period before being made redundant or losing your job. So, for example, insurance exclusions and limitations may apply if you have only been in full-time work for three months and your policy states that you need to have been working for six months.

  • A common income protection insurance exclusion is not approving a claim if you lose your job through your own fault. So, for example, if you are sacked for misconduct then you will not receive benefits. You need to have lost your job through no fault of your own.

  • Permanent health insurance exclusions will generally also apply if you resign or take voluntary redundancy.  

To make sure that the insurance exclusions and limitations that you get with any policy are fair and that they will not make it impossible for you to make a claim you MUST make sure to read through each and every income protection insurance exclusion. The policy documents you get before signing up to this kind of plan will give you a list of permanent health insurance exclusions so there is no excuse for not knowing which insurance exclusions and limitations could apply to you.

Remember, you may find that individual insurers have different permanent health insurance exclusions.  You can’t necessarily pick the income protection insurance exclusion that you don’t like and get rid of it, but you will be able to find fair policies if you take the time to shop around.

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