Do you disagree with the medical or labour expert assessment under your disability insurance (AOV)? Request the full reports and the written decision. Check the facts first, then the medical restrictions and finally how they have been translated to your insured occupation. Submit targeted objections and, where necessary, ask for additional or independent examination. At the same time, keep an eye on the deadlines and on your ongoing benefit.
Nederlands: Lees dit artikel in het Nederlands: Niet eens met verzekeringsarts of arbeidsdeskundige van uw AOV: wat kunt u doen?
Türkçe: Bu makaleyi Türkçe okuyun: AOV sigortanızın sigorta hekimine veya iş uzmanına katılmıyor musunuz? Neler yapabilirsiniz?
Written by Onur Arslan, attorney at Arslan Advocaten. Registered in the Netherlands Bar’s register of specialist areas of law for employment law and personal injury. Onur Arslan practised for many years as a corporate lawyer and insolvency trustee (curator) and has extensive experience in financial law disputes. Last updated: 22 September 2026.
A lower AOV benefit can result from various steps in the assessment. Perhaps medical restrictions were not taken into account, your work was described as lighter than it is, or the wrong policy definition was used. An effective objection shows at which point the reasoning falls short.
Who assesses your incapacity for work?
A medical adviser or insurance physician assesses the medical information and restrictions. Sometimes another medical specialist examines you. A labour expert (arbeidsdeskundige) examines the relationship between your capabilities and the work. The insurer decides on the claim on the basis of the relevant information.
The division of roles can differ from insurer to insurer. The explanation by Allianz of becoming unfit for work, for example, shows that medical information and labour expert guidance are separate parts of the process. For your own file, check who drew up which report and what instructions were given.
A treating doctor has a different role from an expert who assesses the insurance question. The treating doctor can provide important facts, but does not automatically decide on the right to the AOV benefit.
Start with the correct policy and assessment period
Check whether your policy covers incapacity for your own occupation or for suitable work. Ask which definition applies during the period assessed and whether the standard changes after a certain time. Also look at the benefit threshold, the waiting period (own-risk period) and any personal exclusions.
Next, establish which date the report relates to. An examination in June cannot, without explanation, establish all restrictions in February or November. If your symptoms change, the period is important both for the degree of incapacity and for any back payment.
As a product example: the Allianz Absoluut AOV policy conditions (AAOV21) contain separate provisions on determining incapacity for work and on the route to follow if you disagree. In that document, look for the chapters on determining the degree of incapacity for work and on complaints and disputes; they set out the period within which you must object and the procedure for a reassessment or further examination. This is just one product example: always check the procedure and deadlines of your own policy, as they differ per insurer and per policy year.
Building your objection: passage, objection, evidence, request
An objection that merely says “I do not agree” rarely achieves anything. What does work is using the same fixed structure for each point: which passage, what is wrong, what shows this, and what you are asking for. This allows the insurer to respond point by point and makes clear what remains unanswered.
Example: objection to the insurance physician’s report
Re: response to the report of [name of physician] dated [date], policy number [number], claim number [number].
Below I set out, per section, where in my view the report is incorrect. I ask you to respond to each point separately.
Point 1. Passage: “[verbatim quotation, with page and line number]”. Objection: this states that I [X], whereas in fact [Y]. Evidence: see Annex 1, letter from [treating practitioner] dated [date], stating “[quotation]”. Request: I ask you to correct this passage and adjust the conclusion accordingly.
Point 2. Passage: “[quotation about the description of my occupation]”. Objection: [percentage] of my work consists of [task], and this is not reflected in this description. Evidence: see Annex 2, task overview with breakdown of hours, and Annex 3, statement from [client]. Request: I ask that the assessment be carried out again on the basis of the correct occupational description.
Point 3. Passage: “[quotation about the examination date or period]”. Objection: the examination took place on [date], whereas the assessment covers the period [period]. Evidence: Annex 4, overview of the course of my symptoms. Request: I ask you to state the date to which the established restrictions relate and to reassess the benefit for the remaining period.
I request a written, reasoned response to each point within [period] and ask you to let me know whether you are willing to carry out a reassessment or have a further examination performed by another expert. Should you maintain your position, I ask you to confirm it as your final position, stating the internal complaints procedure.
Quote verbatim and state the source; a paraphrase leads to discussion about what was actually written. Attach the annexes numbered and refer to them in the text. Keep a copy with proof of dispatch.
Factual errors in the medical report
Check whether your medical history, medication, treatments and your description of the symptoms have been reflected correctly. For each error, note the passage, the correct information and the evidence. A mistake in dates or duties can affect later conclusions.
Ask how you can have factual inaccuracies corrected and whether there is a draft stage. Not every difference of opinion about a medical judgement is a factual error that must simply be deleted. A substantive disagreement may require a reasoned medical response.
Also look out for missing information. Have relevant specialist documents been mentioned but not discussed? Is it unclear why an earlier restriction no longer applies? Ask for a substantive explanation on those points.
Is your occupation described realistically?
A labour expert report must match the insured work. Check the division of tasks, working hours, physical strain, concentration, customer contact, administration and responsibility. A general occupational description may miss important elements.
A self-employed painter, for instance, does not only do administrative work; a hospitality entrepreneur may work operational shifts personally. At the same time, not every task you performed before you stopped working is set in stone. The policy and reasonable options for adjustment may play a role.
Therefore draw up a task overview for the period before you stopped working, supported by diaries, schedules, assignments and descriptions of the work. Indicate what you can still do now and under what circumstances. Link your objections to specific tasks rather than only to the conclusion that the percentage is too low.
Common errors in a medical assessment
This overview helps you read in a targeted way. Go through your report using the left-hand column and note for each row whether you recognise the point.
| Type of error | How do you recognise it? | Why does it matter? | What do you ask for? |
|---|---|---|---|
| Incorrect medical history | Treatments, medication or diagnoses are missing or incorrect | The conclusion is based on an incomplete picture | Correction, with the treating practitioner’s letter as evidence |
| Occupation described too broadly | “Administrative work” while you also do physical work, or vice versa | The translation to the benefit percentage is based on that description | A new assessment based on a task overview with breakdown of hours |
| Wrong assessment period | Examination in June, judgement on the whole year | Symptoms fluctuate; a snapshot does not cover a year | A statement of the date to which the restrictions relate, and assessment of the remaining period |
| Restrictions cannot be traced | No explanation of why a symptom does not lead to a restriction | A judgement without reasoning cannot be reviewed | Reasons for each restriction, with reference to the findings |
| Only own examination | No information requested from your treating practitioners | Information from treating practitioners is often decisive | Request it after all, with your consent |
| Labour expert does not follow the physician | The physician mentions restriction X, the labour expert does not take it into account | The translation of restrictions into a percentage must be traceable | An explanation of how each restriction has been reflected in the percentage |
| Fluctuating course ignored | “Can work 4 hours” without regard to the relapse afterwards | Sustainability is different from one-off capacity | Assessment of sustained capacity over a full week |
Translating restrictions into a benefit percentage
Check whether the labour expert’s assessment uses the same restrictions as the medical report. If medical information changes, it must be checked whether the labour expert’s conclusion is still consistent with it.
Ask how the percentage was calculated and which tasks are considered feasible. The number of hours you work less does not automatically equal the insured percentage. Nor is loss of turnover the direct standard under every AOV.
Illustrative example: a report assumes a position consisting mainly of light planning tasks, whereas before you stopped working your business relied primarily on your operational work. In that case, substantiating the set of tasks may be more important than a general medical objection.
Independent expert assessment or reassessment
Ask what reassessment options the policy offers. Agree in advance on expertise, independence, the questions to be answered, the file and the costs. A physician with appropriate expertise should assess the medical question; a labour expert the consequences for the work.
Have the status of the outcome recorded. Is it advice, a jointly agreed expert assessment or a binding determination? The significance of the report affects how you can respond to the outcome later.
Not every difference calls for a new examination straight away. Sometimes a supplement to the existing report is sufficient, for example if one relevant document was missed. A completely new report is mainly worthwhile if it can actually resolve the remaining question.
Access, correction and medical privacy
Request access, through the designated route, to the reports used for your claim. Discuss how factual corrections, a response of your own and any other rights in an expert assessment can be exercised. The applicable rights and consequences may depend on the type of examination; do not assume that you can block any unfavourable report without consequences.
Share medical data selectively and securely. Ask which data the claims handler needs and which should remain with the medical assessment. Cooperation may be necessary for the claim, but that does not automatically make every unlimited request for information appropriate.
Objecting while the benefit is being reduced
Ask the insurer for the effective date and calculation of the reduction. Make clear which decision you are objecting to and what additional assessment you require. If you are under acute financial pressure, ask, with reasons, whether continuation or an advance payment is possible.
An objection to a private AOV decision is not the same procedure as an objection to the UWV (the Dutch employee insurance agency). The six-week administrative law deadline therefore does not automatically apply. Check your policy, the limitation period and any complaint deadlines separately. Report improvements, deterioration and any return to work in accordance with the applicable arrangements.
If the insurer maintains its position, a complaints or litigation route suited to the dispute must be chosen. First complete the insurer’s internal complaints procedure and ask for a written final position; that final position is the starting point for the next step. Access to Kifid, the Dutch Financial Services Complaints Tribunal, requires checking the applicable rules of the Kifid Disputes Committee: they set out the conditions for access and the deadlines within which you must file after the final position. Which rules apply depends on the date on which you submit the complaint. In civil proceedings, the reports, the questions to experts and the burden of proof may once again play a central role.
Frequently asked questions about AOV assessments
Can I demand a different insurance physician?
Not as a matter of course. State specific objections regarding expertise, independence or the way the examination was carried out. Check the policy procedure and discuss a suitable solution or an independent expert assessment.
May I bring someone to an examination?
Ask the examiner in advance and discuss any conditions. Indicate what support you need. The nature of the examination may be relevant to what is practically possible.
Is a report wrong if my GP disagrees?
Not automatically. A difference must be explained on the substance. Ask which medical facts, restrictions or questions lead to different conclusions and whether further information is needed.
Is a second opinion always paid for?
No. The cost arrangement depends on the policy and on what has been agreed. Before instructing anyone, ask for written clarity about the expert, the questions and the reimbursement.
May the insurer reduce my benefit while I am objecting?
An objection does not automatically suspend the decision. Whether the reduction is justified and can be stopped for the time being depends on the policy, the reasoning and the circumstances. In urgent cases, seek legal advice in good time.
What if the dispute is mainly about long COVID or chronic pain?
Then the medical standard may require extra attention. Also read AOV in cases of burnout, long COVID and chronic pain.
Show where the assessment falls short
Would you like an AOV report to be reviewed? Contact Arslan Advocaten with your policy and the decision. For the wider process, see also AOV benefit refused or terminated.
Legally reviewed by Onur Arslan, attorney at Arslan Advocaten. Reviewed on 13 September 2026.
