How insurers calculate the sum, which clauses in the comparison text are dangerous, and what you can lose beyond your pension.
Is your disability insurance offering you a one-time lump sum payment instead of your ongoing pension? Such a settlement can be advantageous, but almost always means completely waiving future entitlements. Whether this is worthwhile depends on the amount of the payment, any problematic clauses, and which other benefits you are relinquishing. Rogert & Ulbrich will review the offer before you sign.
What a settlement offer is and why the insurer makes it
In a settlement payment, the insurer pays a one-time lump sum, thereby ending its obligation to continue paying the ongoing occupational disability pension. The contract, or at least the entitlement to benefits, is definitively settled in exchange for this lump sum payment.
This offers a clear advantage for the insurer. Disability insurance payments can run for decades. A lump-sum settlement limits the insurer's risk and eliminates an uncertain, long-term obligation. Lawyer Dario Kovac, based on his previous experience working for insurance companies, knows that lump-sum settlements are often offered when future payments are expensive or uncertain for the insurer, for example, before a review.
That's precisely why you shouldn't misunderstand an offer as a mere concession. It's based on a sound business calculation, which you should also be making.
Have you received a severance offer? Have it reviewed before you agree. Also, how to deal with a threatened severance payment. Insurer's refusal to pay benefits plays a role in this.
How the insurer calculates the settlement
There is no legal formula for the amount of the severance payment. The insurer capitalizes the anticipated future pension payments, thus converting the future monthly payments into a single lump sum today. Several assumptions are factored into this calculation:
- Remaining timeHow long would the pension likely continue to be paid, usually until the agreed end of the benefit period?.
- Reactivation probabilityHow likely is it, from the insurer's point of view, that you will recover and the pension would not be payable anyway?.
- DiscountingFuture payments will be discounted to their present value, which significantly reduces the total amount.
The insurer has some leeway in all these assumptions, and they regularly use it to their advantage. A high probability of reactivation or a short assumed remaining term reduces the payout. Therefore, a settlement is always negotiable, and the first offer is rarely the best.
Does the offer seem low to you? Have the underlying calculation checked before you negotiate or accept.
Problematic clauses in the comparison text
It's not just the amount that matters, but also the wording of the settlement. These clauses are particularly sensitive:
- Waiver of all further claims: Clauses stating that payment settles all claims arising from the contract also exclude any subsequent deterioration of your health.
- Exclusion of future benefitsIf you waive any unknown or future claims, you will no longer be able to assert any rights, even if new circumstances arise.
- Cancellation of the entire contractIf the contract is completely cancelled, you also lose coverage for future, new illnesses. A new disability insurance policy is often more expensive later on, or even impossible to obtain.
Once signed, a settlement agreement generally cannot be amended. Therefore, each of these clauses should be carefully reviewed before signing.
Does the comparison text contain a comprehensive waiver? Have it checked to see what you are actually waiving.
When a severance payment is worthwhile and when it isn't
Whether a settlement makes sense depends on the individual case. Arguments in favor of a severance payment include:
- Planning certaintyYou receive capital immediately and are independent of future audits by the insurer.
- Real uncertaintyIf the outcome of a retrial is uncertain or your condition might improve, a safe amount today may be attractive.
- Specific capital requirementsFor example, to pay off debts or for a career change.
On the other hand, there are often arguments against a severance payment:
- Long remaining service lifeIf you are young and your pension would last for many more years, the capitalized value is high. A severance payment that is too low then means giving away a lot of money.
- Stable, severe illnessIf an improvement is unlikely, the ongoing pension is usually more valuable than a lump sum payment.
- Loss of important building blocks: If you lose a contribution exemption, additional benefits or future protection as a result of the settlement.
Therefore, comparing the offered pension with its actual value is at the heart of every decision.
Are you unsure whether the comparison is worthwhile for you? Have the offer and pension value compared.
Exemption from contributions, subsequent insurance and additional benefits
Beyond the purely financial considerations, what else you might lose through a settlement often becomes a decisive factor. A severance payment usually not only terminates pension payments but can also settle other aspects of the contract:
- Exemption from contributionsIf the disability insurance is part of a larger contract, such as a waiver of premium for a life or pension insurance policy, this waiver may be cancelled with the severance payment. You would then either have to pay premiums yourself again or lose the benefit component.
- Follow-up insurance and future protectionIf the contract is completely cancelled, you will also lose coverage for future illnesses and any guaranteed insurability options. Obtaining a new disability insurance policy later is often more expensive or even impossible.
- Additional servicesAdditional benefits included in your policy, such as coverage for serious illnesses or reintegration assistance, may also be lost in the settlement. Check what your contract includes beyond the pension.
The economic value of a severance payment is therefore not solely determined by the amount, but also by which of these components you relinquish. A settlement that adequately reflects your pension but also eliminates valuable additional rights can ultimately be disadvantageous.
Is the settlement intended to cancel the entire contract? Have it reviewed to determine which components beyond the pension payments will be lost.
What you should check before signing
Before accepting a severance offer, you should clarify the following points:
- Calculate pension valueHave the capitalized value of your pension calculated and compared to the offer.
- Question the calculation: Check the insurer's assumptions regarding remaining term, reactivation and discounting.
- Check comparison text: Pay attention to comprehensive waiver clauses and the loss of premium exemption, additional benefits and future protection.
- Clarify tax implications separatelyThe tax treatment of a severance payment depends on the individual case and should be reviewed in advance with a tax advisor.
- Do not sign under pressure.A legitimate offer deserves careful examination. Don't let yourself be pressured into a quick commitment.
This article is part of our series on disability insurance. You can find an overview of our work and further points of contention on our website. Lawyer specializing in disability insurance.
The more thoroughly you examine an offer, the better your negotiating position. Have the comparison reviewed before you sign.
Rogert & Ulbrich – Your lawyers in insurance law
Rogert & Ulbrich represent policyholders nationwide in disputes with their disability insurance companies, including settlement offers. Attorney Dario Kovac, who is familiar with insurers' review and rejection strategies from his previous work on the insurers' side, serves as the contact person. We combine this insider knowledge with the firm's consumer protection experience from major cases in banking, capital markets, and automotive law. This allows us to engage with insurers on equal footing.
We review the settlement offer, calculate the value of your pension, scrutinize the insurer's assumptions, and examine every waiver clause in the settlement agreement. During the Examination and enforcement of claims arising from insurance contracts We represent you out of court and, if necessary, in court. We involve any existing legal expenses insurance early on and obtain the coverage confirmation for you.
Has your disability insurance provider offered you a settlement? Get in touch and have the offer reviewed before you sign.
