ESA and Income Protection Insurance

Can I ask if anyone has experience of claiming Income Protection Insurance alongside Incapacity Benefit / ESA?

What effect has your claim (for WRAG or Support ESA) had on your insurance company when they have reviewed you? If you have been placed in the working group, has this been a "red light" to your insurance company to state you are fit for work and end your claim?

I have been receiving Income Protection Insurance alongside Incapacity Benefit for a number of years and am concerned about how my insurance company will react to new ESA guidelines. I have a degenerative condition which causes chronic pain and regular bouts of immobility. I was too ill to attend the ESA medical recently and my GP wrote a comprehensive letter detailing my condition and how it affects me and to request a home medical. This was ignored, it seems, and without a medical I have been placed in the WRAG and not the Support Group (where I and my GP believe I belong). I am considering an Appeal and have spoken to welfare rights organisations and read the highly informative advice on this site.

However, I am concerned about the effect an Appeal (and specifically losing one) may have on the insurance company. Anyone in receipt of this kind of insurance will know how hard it is to try and keep it after an initial claim.

So I would be very grateful to hear from anyone who also receives Income Protection Insurance and what their experience is or has been.

Hi i am in exactly the same boat so know how you feel, i feel that the dwp has left me with no option but to appeal. While i agree there needs to be a crackdown i cannot for the life of me believe the goverment is doing this to genuine cases and causing so much stress, worked since i was fifteen and never recieved anything in my life. Recently had to give up my well paid job of 20 years due to a life threatening illness, in reciept of insurance which i have paid for for over 15 years and now the dwp have placed me in wrag without medical, my insurance are going to love this, it's so wrong .

Hi,

Can I just remind you both that being placed into the WRAG of ESA, is not a "fit for work" decision.

It has been deemed that you "May" be fit for work at some time in the future.

As you are both new to the forum, you may wish to read :

Welcome to Benefits and Work

You may also wish to peruse our FAQ's here:

FAQ’s

And our recently updated ESA Appeals Guide Jan 2012, can be accessed from here :

ESA Guides

If you intend to appeal the WRAG award, it may help if you read :

Qualifying for the Support Group

ESA medical – what forms to ask for?

ESA Forms

How long do I have to appeal?

How to submit an appeal

Is there any risk to challenging a decision?

How long to hear an appeal?

Work Focussed Interviews, (WFI’s)

Work Programme

Do I have to attend WFIs while I appeal?

bro58

Hi,

Not sure if this will be of any help.

I will try to keep this brief.

My friend gets PHI which she took out some years ago personally and not through her employers. Her policy was for "own occupation".

Unfortunately she fell ill some years ago and made a successful claim under her personal PHI and was also awarded incapacity benefit to be reviewed after 5 years!!!, but her insurer were reviewing her every year and deducting DWP payments.

She questioned her insurers as to why they would not accept DWP's decision on a 5 year review and was told that insurers had a different assessment criteria to DWP.

She is now waiting for the results of her transfer to ESA and has made it clear to her insurers that if for any reason her ESA should stop she expects her PHI payments to continue(as long as she meets their criteria) as when she was on IB, they did not want to use DWP's Assessments.

If you took out your policies personally through a financial advisor, then if i were you i would seek their advise. If the policy was throgh your ex-employers then i would get help in understanding the assessment criteria.

Regards.

Radhika.

You could start by checking the terms of your insurance policy. What is the insurance company's definition of unable to work? Is it unable to work in your "usual occupation" or any sort of work?

Hi,

By the way i forgot to mention that my friends financial advisor who sold her the policy told her that he believed and with his clients experiences, that once the insurer had started to pay disability premiums the onus would be on them to prove she was fit for work as before paying her, they sent her to be assessed by their own indedpendant Doctor for assessment and based their decision on His/Her report and supporting medical evidence from her GP and specialists and has been using the same criteria when assessing her every year!!!!

Hope this gives you guys some peace of mind and be able to concentrate on your EAS forms/appeals.

Also remember, that if your insurers continue to pay you, will DWP take that into consideration and change their decisions from WRAG to S/G?????

I think we all know what the answer to that one.!!!!

Regards.

Radhika.