Avéro Achmea · compared independently · advice from Finass
WGA gap insurance through Avéro Achmea
WGA gap insurance tops up the income of partially disabled employees who fall back on the WGA follow-up benefit because they do not make full use of their remaining earning capacity.
The calculator and the quote form below are in Dutch. Prefer to do this in English? Email info@finassverzekert. nl or call 072 - 509 24 56 and we will take it from there.
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A premium indication, not personal advice. Prefer to talk it through? Call 072 - 509 24 56.
In brief
The gap this insurance is named after lies within the WIA itself. An employee who is declared between 35 and 80 per cent incapacitated for work after two years of illness first receives a salary-related benefit whose duration depends on his employment history. The follow-up benefit comes next, and that is no longer based on his former salary but on the minimum wage and his percentage of incapacity.
Anyone who succeeds in making sufficient use of his remaining earning capacity moves into the salary supplement benefit and notices little of it. But it is precisely the employee who cannot find suitable work who falls back on an amount unrelated to what he used to earn. For someone on an average or higher salary that fall is drastic, and it comes at exactly the moment when reintegration has stalled.
WGA gap insurance repairs that fall. It is something other than a WIA insurance which tops up income above the statutory salary ceiling. The one concerns a gap within the statutory scheme itself, the other income that never counted towards the WIA.
The structure of the cover in three parts, with an overview per situation below.
Basic cover
The basic cover insures the core of your WGA gap insurance. We show what Avéro Achmea and other insurers offer within it.
Injury to persons
Property damage to third parties
Employees included
Retroactive cover (prior risk)
Extended cover
On top of that to damage to third parties, employers' and product liability and damage during work at the client's premises.
Employers' liability at the client's premises
Product liability
Agency workers, interns & volunteers
Care, custody and control (property in your care)
Complete package
The most complete cover. We compare Avéro Achmea's extended version with the market.
Environmental impairment (unforeseen, limited)
Retroactive cover (prior risk)
Higher sums insured
What is covered
Situation
Basic
With extension
Permanent disability after an accident
Yes
Yes
Death caused by an accident
Yes
Yes
Incapacity for work due to illness
No
Provided that
Continued payment of wages during sickness absence
No
Provided that
Reintegration and guidance
Provided that
Yes
Complaints that already existed when the policy was taken out
No
No
With accident and income cover, the definition of «accident» or «incapacity for work» determines what is paid out, together with the waiting period, the end age and the occupational profile. A condition that already existed or was known when the policy was taken out is usually excluded; non-disclosure can affect the payout (Articles 7:928 and 7:930 of the Dutch Civil Code).
What we do
What we do
At Finass
Direct with Avéro Achmea
Comparison across several insurers
Yes
No
Advice based on your own situation
Yes
Sometimes
One point of contact for claims
Yes
Sometimes
Cancellation with your current insurer arranged
Yes
No
We determine whether Avéro Achmea is the best choice
Yes
No
Advice fees for you as a customer
No
No
This overview concerns our service, not the cover. What is actually covered is set out in the policy conditions and on the insurer's insurance card (verzekeringskaart); you receive both before you take out cover.
Where things go wrong in practice
Four points that make the difference between a policy that pays out and one that does not.
Where the follow-up benefit hurts
For as long as the salary-related benefit runs, income stays reasonably on a par. Once that period ends, UWV (the Dutch employee insurance agency) switches to the follow-up benefit, the level of which is derived from the minimum wage and the incapacity class. The former salary no longer plays any part in it. The higher someone's earnings were, the bigger the fall. Employers only notice it when it happens, because there is easily three years between the sickness report and the follow-up benefit.
Basic or extended
In the basic form the insurance only pays out once the follow-up benefit starts and the benefit is geared to the gap that then arises. In the extended form the supplement runs from the start of the WGA period and the difference during the salary-related phase is made good as well. Which form is needed depends on the collective labour agreement and on whether a supplement already exists on a collective basis. Both forms stop at state pension age.
What falls outside the cover
No benefit is payable where incapacity for work is less than 35 per cent, because there is then no entitlement to WIA and therefore no gap. People entitled to IVA benefit are also outside it: they are fully and permanently incapacitated for work and receive a higher statutory benefit with no follow-up phase. Also excluded: employees who were already ill when the insurance started, and benefits that UWV refuses or reduces because of insufficient reintegration effort.
Participation, collective agreement and enrolment
The cover is taken out collectively for the workforce. Many collective labour agreements require the employer to offer WGA gap cover or even to take it out for everyone. An employer who fails to do so can be held liable by an employee under Article 7:611 of the Dutch Civil Code because, as a good employer, he should have informed them. Enrol new employees straight away and remove employees who fall ill straight away, otherwise there will be argument about the start date of the cover.
Retroactive cover (prior risk)
Retroactive cover (prior risk) Included for your staff during work.
Defence & legal costs
What does your premium depend on?
Payroll and salary structure. The gap to be repaired is larger the further the salary lies above the minimum wage.
Age profile of the staff. Older staff statistically have a higher chance of long-term incapacity for work.
Sector and nature of the work. Physically demanding work or work with a high mental burden more often leads to entry into the WGA.
Version chosen. The extended form, which also tops up the salary-related phase, is more expensive than the basic form.
Participation rate. Compulsory participation for the whole workforce prevents only the risk cases from signing up.
Sickness absence and WIA entry history. The number of employees who have entered the WIA in recent years is taken into account.
Insurers weigh these details differently. That is where your saving is.
How we arrange it
You request a quoteWe take stock of your situation, your risk and your wishes.
We compareseveral insurers, on premium as well as conditions.
You receive a proposalWith an explanation of the differences and the exclusions.
We arrange the switchIncluding cancellation, so there is no gap in cover.
Customers rate our service on four aspects: personal service, service delivery, availability and the outcome. The reviews are collected and published by NH1816 and come from customers who have actually taken out a policy with Finass Advies B.V. or reported a claim.
WGA gap insurance repairs a gap within the statutory scheme: the fall back to the follow-up benefit for those who are partially incapacitated. WIA excess cover concerns income above the salary ceiling, on which UWV never pays out in any case. For employees on a higher salary both are relevant, because they run up against both limits. For a workforce around average earnings the gap is usually the bigger problem.
When exactly does the benefit start?
In the basic form, as soon as the salary-related WGA benefit ends and the follow-up benefit begins. That moment comes after two years of continued salary payment plus the salary-related period, which depends on the employee's employment history. In the extended form the supplement runs from the start of the WGA. UWV's decision on the degree of incapacity is decisive in both cases.
What if the employee does work to the extent he is able?
He then moves into the salary supplement benefit and the gap is small or non-existent. So the insurance matters above all for those who do not use their remaining earning capacity, for example because there is no suitable work. That also makes active reintegration worthwhile financially: every hour someone does work reduces both the gap and the benefit burden.
Does the cover continue if an employee leaves?
The insurance is attached to the employment contract. If someone leaves while in good health, his participation ends and he can often continue it individually within a short period. If he was already incapacitated for work when he left, the benefit in payment usually continues. So always report the end of employment in good time, stating the state of health at that moment.
Finass Verzekert is a trading name of Finass Advies B.V. We advise on and arrange non-life insurance on the basis of an objective analysis of several insurers, and receive commission for this from the insurer, which is included in the premium. You pay no separate advice fee. Before you take out cover, we establish your wishes and needs.
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