Basic group WGA shortfall insurance
Informatiedocument over het verzekeringsproduct
- Onderneming:
- Elips Life Ltd, life insurer, license: 110355 (LI)
- Product:
- WGA-vervolghiaatverzekering
This document only provides a summary of the key features of the insurance. You will find all the terms and conditions in the general conditions and the special conditions.
If an employee becomes incapacitated for work, the UWV may grant a follow-up benefit under the Return to Work (Partially Disabled Persons) Regulations (WGA follow-up benefit) after 104 weeks of illness. With the WGA follow-up shortfall insurance, you insure a supplement to this WGA follow-up benefit for your employees.
An employee who is incapacitated for work may receive a WGA follow-up benefit. This applies if the employee is 35% or more, but less than 80% incapacitated for work and if they earn less than 50% of what they could still earn with their limitations according to the UWV (known as their residual earning capacity).
If your employee is partially incapacitated for work, the insurance pays 70% of their insured salary minus the minimum wage. This result is multiplied by the benefit rate.
The employee’s salary capped at the WIA wage limit is the insured salary on which we base our benefit payment. The benefit starts after we receive the UWV’s definitive decision and no earlier than 104 weeks after the first day of illness.
You insure all your employees who must be insured for the employee insurance, including employees on temporary contracts.
We reimburse all or part of the reintegration costs that we have pre-approved in writing.
We will not pay if the employee was ill or incapacitated for work when they took up employment. We will also not pay if the employee was already sick or incapacitated for work when you took out the insurance.
If a sick or incapacitated employee takes up employment due to a change in the business situation, such as a merger or acquisition, they are not covered by this insurance.
We will not pay if fraud has been committed.
We will not pay if:
This insurance only supplements the WGA follow-up benefit to a limited extent.
An employee will not receive a benefit under this insurance if they:
The salary above the WIA wage limit is not co-insured. The government determines the WIA wage limit.
This insurance applies to employees paying income tax in the Netherlands and provides worldwide coverage.
Let us know if an employee is incapacitated for work within 42 weeks of their first day of illness.
Register employees within two months of the start of the insurance or, if later, within two months of the date of commencement of employment. The employee must be fully fit for work and be performing the agreed work at that time.
You and your sick employee must do everything possible to ensure that the employee can return to work. You and your employee must comply with the policy conditions and the obligations imposed by the UWV.
All information required to implement this insurance must be made available to us. This includes income data and changes in the degree of incapacity for work.
Health
If you request this insurance, we will not ask about your employees’ health.
You pay the premium each year. The premium must be paid within thirty days of the invoice being sent. If the premium is not paid after a reminder and a final payment deadline, the cover lapses.
Premium
Your premium percentage depends on the type of business you run and factors such as your employees’ salaries and ages, and the number of employees who have been previously incapacitated for work.
The insurance starts on the date specified in the policy. The standard policy term is three years. At the end of those three years, we will make you a proposal to renew your insurance, unless we cancel your insurance and do not make a proposal for renewal.
Your employee’s cover ends at their state pension (AOW) age, when they leave their employment, on their death or on termination of the insurance. The benefit runs until their state pension age at the latest.
If you fail to pay the premium on time, we can terminate the insurance.
Give us written notice of termination no later than two months before the end of the first contract term. After the first contract term, you can give notice of termination of the insurance on any day in writing subject to a one-month notice period, unless we have agreed a new contract term with you.