Continued payment of wages
- First year one hundred per cent
- Second year seventy per cent
- A collective labour agreement may require more
Wages · guidance · sanction risk
Full-service sickness absence insurance: who takes the lead?
This type of policy insures not only the continued payment of wages but also transfers control of the gatekeeper process to the insurer, on the condition that you follow the instructions of its case manager.
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Deze pagina in het Nederlands: Verzuim-ontzorgverzekering: wie voert de regie?.
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- We compare the offerings of several insurers
- An adviser checks whether the cover suits your activities
- We arrange the switch, including cancellation
A premium indication, not personal advice. Prefer to talk it through? Call 072 - 509 24 56.
In brief
The SME absence support insurance is a package: continued payment of wages during illness, occupational health services and absence guidance are in one contract, and the insurer takes on the risk of an extended obligation to pay wages. It is intended for employers who have no HR department and do not want to monitor the two-year process themselves. Where with a conventional sickness absence insurance you only buy money, here you mainly buy trim level.
That transfer is conditional. The insurer's case manager determines the steps: involving the company doctor, the plan of action, the first-year evaluation and the moment the second track starts. If you do not follow a piece of advice, do not offer the suitable work proposed, or deliver the file late, the insurer can still leave the sanction with you. So read exactly what obligations the conditions place on you; with this form that matters more than the difference in premium.
The cover ends after 104 weeks. What follows after that, the WGA costs and the differentiated contribution, falls under WIA or WGA insurance and not under this policy. We compare this form with the stop-loss version, which is based instead on a threshold amount and on managing the process yourself, so that you can see which approach suits the size of your business.
What does full-service sickness absence insurance for SMEs cover?
The structure of the cover in three parts, with an overview per situation below.
Own retention
How many days you bear yourself.
- Shorter is more expensive
- Longer brings the premium down
- Choose according to what you can bear
Support and case handling
Guidance with reintegration.
- Case management
- Gatekeeper Act monitoring
- Risk of a wage sanction
What is covered
| Situation | Conventional | Full-service option |
|---|---|---|
| Continued payment of wages during sickness | Yes | Yes |
| Guidance with reintegration | No | Yes |
| Risk of a wage sanction borne by the insurer | No | Yes |
| Occupational health services included | No | Sometimes |
| Cost of replacing a member of staff who is off sick | No | No |
| Sickness absence that already existed at inception | No | No |
This overview is general in nature and is not personal advice. What is actually covered, including exclusions, limits and the excess, is set out in the policy conditions and the insurance card (verzekeringskaart) of the insurer; you receive both before you take out cover. Taking out cover without advice? Then read what execution only means for you.
Where things go wrong in practice
Four points that make the difference between a policy that pays out and one that does not.
You are buying delivery, not just a payment
The distinguishing feature is the process. With this form the insurer arranges the occupational health services and appoints a case manager who monitors the file. With a conventional policy you organise that yourself and keep full control, at a lower premium. If you have no HR officer and absence is rare in your business, the chance of a procedural error is real and that delivery weighs more heavily than the difference in price.
The condition behind the sanction cover
The insurer takes over the risk of an extended obligation to pay wages as long as you cooperate. In concrete terms: reporting illness in good time as Article 7:941 of the Dutch Civil Code requires, carrying out the advice of the company doctor and the case manager, and keeping the reintegration file complete. If you choose your own reintegration agency without involving them, or let a proposed programme lapse, that transfer falls away and you pay a third year of wages yourself after all.
What you must declare at the start
Because the insurer also runs a delivery risk here, acceptance carries a lot of weight. Article 7:928 of the Dutch Civil Code requires you to declare current absence, long-running cases and your absence history in full. If it turns out afterwards that you did not report a sick employee or a threatened absence, the insurer can, under Article 7:930 of the Dutch Civil Code pay proportionally or not at all. So go through your absence records before the start date.
Where the cover ends
Not covered are absence already running on the start date, the pregnancy and maternity leave (that is the WAZO), and everything after the 104-week period, including entry into the WGA. The costs of a replacement, fines from the Dutch Labour Authority and loss your employee recovers from you under Article 7:658 of the Dutch Civil Code also fall outside the cover. Loss caused intentionally is excluded in any case by Article 7:952 of the Dutch Civil Code .
What does your premium depend on?
- Insured payroll — The basis for calculating both the continued payment of wages and the service element of the package.
- Number of employees — With a small workforce one long-running case weighs heavily; that is reflected in the loading.
- Sector and absence history — Your activity and your own absence record determine how much guidance the insurer expects to provide.
- Deferment period — With this form often short or absent, because the guidance starts on the first day of illness.
- Percentage of cover and the second year of illness — Whether you insure 70 or 100 per cent and whether the collective agreement top-up in year two is included.
- Scope of the occupational health and case management package — Which company doctor hours, interventions and reintegration services are included and which are invoiced separately.
Insurers weigh these details differently. That is why comparing pays off.
How we arrange it
- You request a quoteWe take stock of your activities, turnover and 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.
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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.
Frequently asked questions
The questions we are asked most often about this.
What is the difference with a conventional sickness absence insurance?
With the conventional form the insurer covers the wages and you carry out the gatekeeper process yourself, with your own occupational health service and your own risk of an extended obligation to pay wages. With the support form the delivery is part of the contract and the insurer takes over that risk as long as you follow its instructions. The premium is therefore higher and your freedom of action lower.
Does the insurer really take over the extended payment of wages?
Yes, but only if you have demonstrably cooperated. The conditions link that transfer to reporting illness in good time, carrying out the advice and keeping a complete file. If you set aside a piece of advice or do not respond to requests from the case manager, the insurer can refuse to take it over. So record your contact with the case manager in writing.
May I keep my own company doctor or occupational health service?
Often not as a matter of course. The hallmark of this type of policy is that the occupational health services are included and that the insurer manages its own chain of providers. Some providers allow an existing contract, usually on amended conditions or with the loss of the sanction cover. If you have a current basic contract under the Working Conditions Act, report that with your application.
Does this insurance also cover the WGA costs after two years?
No. The cover runs until the end of the statutory 104-week period of continued wage payment. If your employee then enters the WIA, that ends up in the differentiated contribution or with your WGA insurer if you bear your own risk. If you want to cover that stage as well, separate WGA or WIA insurance is needed alongside this policy.
Read more
Similar pages
- Conventional sickness absence insurance (verzuimverzekering)
- Sickness absence insurance (verzuimverzekering) for healthcare
- Stop-loss sickness absence insurance (verzuimverzekering)
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About our service
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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This page was written and checked by an adviser at Finass Verzekert. Last updated on .
The information on this page is general in nature and is not personal advice.