Sickness loss of earnings insurance
Sickness and salary
The law provides that in principle the employer must pay the salary of his or her employee, for a certain period of time depending on his or her years of service, when he or she is unable to work. When the employee has spent a good part of his or her career in the company, the employer will be obliged to pay his/her salary for several months in case of illness.
In order to avoid finding him/herself in a situation where he/she has to pay the salary of a sick employee for several months, the employer can take out loss of earnings insurance. This allows the employer to better control the costs.
The employee also benefits from it if he/she is unable to work for a longer period of time. Loss of earnings insurance usually provides for the payment of wages for a longer period than the employer is obliged to.
The employer sometimes takes out loss of earnings insurance and thinks that he/she is relieved of any obligation to pay wages in the event of illness. This is not always the case. In order to be lawful, loss of earnings insurance must meet certain minimum requirements in terms of salary coverage, duration and premium coverage.
Salary paid after a waiting period of several days, salary not fully covered, limited duration of salary payment, payment of premiums: the general insurance conditions are sometimes unclear. The employer must pay attention to this. If the loss of earnings insurance does not meet certain conditions, the employer will be obliged to pay the employee's salary in the event of illness.
End of payment
The loss of earnings insurance sometimes stops paying daily allowances to the employee, especially when it considers that the employee is not really unable to work or when the employee goes abroad. This situation is particularly delicate when the employee maintains, with a medical certificate, that he or she is unable to work while the insurance company maintains the opposite.
The beginning and end of coverage by the loss of earnings insurance is determined by its general conditions. In principle, the employee is covered for the duration of the employment relationship.
The situation is more delicate when the employment contract ends. Under certain conditions, the employee can ask to continue to be covered by the insurance.
The family of an employee who is ill offers to send him/her abroad to rest. The employee jumps at the chance to spend some quality time with his/her family and accepts. In such a case, the loss of earnings insurance may refuse to pay the employee's salary. The employer's obligation to replace the insurance and pay the salary is limited.
Scuba diving, skiing, mountain hiking, food poisoning... There are many opportunities to get injured or sick during a sabbatical leave. During an unpaid leave, the employee does not receive his or her salary from the employer, even in case of accident or illness. Is he/she still covered by the loss of earnings insurance?
During a pregnancy, the employee tends to get tired more quickly, to feel nauseous or to have back pain. She can leave her work or not go to work, without any other condition. However, the case will only be covered by the health insurance if it is a real incapacity to work. The distinction is sometimes not easy to make.