New claim refused
The insurer says the medical evidence does not establish incapacity under the policy or that you can continue performing the material duties of your occupation.
Income protection claim disputes
Income Protection Claim Refused or Payments Stopped?
Income protection disputes often arise because an insurer says you no longer meet the policy's definition of incapacity, can return to work, can perform another occupation, or are entitled to less benefit than you expected. We review the policy wording, medical and occupational evidence, and the insurer's reasoning before identifying the strongest realistic next step.
✓Free Initial Review
✓Medical & Occupational Evidence Review
✓FOS Complaint Support
✓Litigation & Barrister Routes
Why income protection claims become disputed
The Dispute Is Usually About Whether You Still Meet the Policy Test
An insurer may accept that you have a medical condition but still dispute whether it prevents you from working to the extent required by the policy. The exact incapacity definition, your occupational duties and the evidence all matter.
Existing payments stopped
Benefit has been paid for months or years but is terminated after a medical review, functional assessment, surveillance or another reassessment.
Insurer says you can do another job
The dispute concerns an "any suited occupation", "any occupation" or similar policy test and whether the alternative work is realistically within the definition.
Benefit amount appears too low
The insurer's calculation may depend on pre-disability earnings, other income, state benefits, policy limits or provisions affecting self-employed claimants.
Return-to-work or rehabilitation dispute
The insurer says rehabilitation, reduced hours or alternative duties mean the claim should reduce or stop, while you believe your capacity remains materially limited.
Claim delayed during investigation
Medical records, occupational information, earnings evidence or further assessments are repeatedly requested without a clear decision or timetable.
What IDS reviews
Medical Evidence Is Only Part of an Income Protection Claim
The insurer also needs to apply the policy's incapacity definition to the work you actually did and, in some policies, to other occupations you may be suited to. We focus on the points that genuinely determine entitlement.
The incapacity definition
We identify whether the policy applies an own-occupation, suited-occupation, any-occupation or another test, and how that wording changes over the life of the claim.
Your real occupational duties
The material and substantial duties of your role are compared with the insurer's description of what it believes you can still do.
Medical and functional evidence
Consultant reports, GP evidence, occupational-health material, functional assessments and other evidence are reviewed against the policy test.
The benefit calculation
Where payments are disputed, we look at the earnings basis, deductions, proportionate benefit, rehabilitation provisions and other factors affecting the amount paid.
Financial Ombudsman approach
What Does the Financial Ombudsman Look At?
The Financial Ombudsman says most income protection complaints involve either a new claim being rejected or an existing claim being stopped. It looks at the evidence about the consumer's health, the policy terms and the person's ability to perform duties related to their occupation under the applicable definition.
It can also consider whether the insurer has calculated the benefit correctly and how provisions such as deferred periods, rehabilitation or proportionate benefit have been applied.
Read the Financial Ombudsman's current guidance on income protection insurance.
How we approach the dispute
From Refusal or Termination to a Focused Challenge
The aim is to establish exactly why the insurer says the claim no longer meets the policy and whether its conclusion is supported by the medical, occupational and financial evidence.
Identify the policy test
We establish the applicable incapacity definition, benefit provisions and the precise reason given for refusing or stopping the claim.
Test the insurer's evidence
The insurer's medical, functional and occupational conclusions are compared with your treating evidence, job duties and other relevant material.
Escalate where appropriate
The next stage may involve additional evidence, an appeal or complaint, FOS where eligible, or more formal dispute and barrister support in suitable cases.
What to send us
Start With the Decision and the Evidence Behind It
You do not need to compile a perfect file first. Send what you have and we can identify which further evidence may matter.
The insurer's refusal, termination or review letter
Policy schedule and income protection wording
Consultant, GP and occupational-health evidence
Your job description or summary of occupational duties
Functional assessments or surveillance evidence supplied
Earnings, benefit calculations and complaint correspondence
When the dispute needs to go further
Stopped Payments Can Create an Immediate Financial Problem
Income protection disputes can be particularly serious where a long-running monthly benefit suddenly stops. Depending on the value, evidence and legal issues, IDS can help organise the case for escalation and, where appropriate, facilitate specialist barrister advice or representation.
Insurer appeal or structured complaint
Financial Ombudsman support where eligible
Medical, occupational and financial case preparation
Specialist barrister advice or representation where appropriate
Common questions
Income Protection Claim Dispute FAQs
Can an insurer stop income protection payments after previously accepting the claim?
Potentially, if the policy permits review and the insurer concludes that the applicable incapacity definition is no longer met. But the decision should be supported by appropriate evidence and the policy wording. A previous acceptance does not prevent review, but neither does a review automatically justify termination.
What if my doctor says I cannot work but the insurer disagrees?
The insurer may consider other medical or functional evidence and apply its own policy definition of incapacity. The useful question is how the competing evidence addresses the actual duties of your occupation and the precise test in the policy.
What if the insurer says I could do a different job?
That depends on the wording. Some policies move from an own-occupation test to an any-suited or any-occupation definition after a period of time. The proposed alternative work should be considered against the policy definition, your experience, capabilities and the evidence.
Is the initial review free?
Yes. The initial review is free and there is no obligation to proceed. If further work appears appropriate, the proposed scope and pricing can be explained before you decide what to do next.