The Verwilghen Act

Due to dismissal, retirement or other reasons, you may lose the right to participate in your group medical insurance. That is why your employer provides you with the option of taking out an individual continuation. Moreover, there is a possibility of pre-financing via a waiting policy.

Individual continuation

What is individual continuation?

If you are no longer entitled to this to this occupational health insurance policy, you will be given the opportunity to continue the insurance as an individual together with the family members already included in this insurance. This continuation can be continued without any waiting periods or medical formalities, provided that a number of conditions are met.

What are the entry conditions?

In order to continue the insurance individually without any waiting periods or medical formalities, the principal insured must have been part of one or more consecutive insurance policies for hospitalisation and medical expenses with an insurance company for at least two years continuously before the affiliation end date. You can only continue your insurance individually if you were affiliated for at least two years continuously before the affiliation end date.

Any pre-existing conditions already covered at the time of taking out the occupational health insurance policy will remain insured in the individual contract.

What terms are applicable?

As principal insured party

Your employer will inform you of the possibility of individual continuation by e-mail or by letter within thirty days of the end of this insurance benefit. You will have a thirty-day term to inform Vanbreda of your intention to continue the insurance either in full or in part. This period will be extended by thirty days if you inform Vanbreda of this by e-mail or by letter.

These terms start from the date the employer informs you of the end of the occupational health insurance benefit policy and the possibility of individual continuation by letter or by e-mail. In all cases, this term will expire one hundred and five days after the end of the occupational health insurance policy benefit.

As additionally insured party

The terms applicable to the principal insured as described above will also apply to the family members. A different term will only apply if the family member loses the occupational health insurance policy benefit for a reason other than the principle insured’s loss of the occupational health insurance policy benefit. In that case, the family member will have a term of one hundred and five days to inform Vanbreda of the intention to exercise the right to individual continuation by e-mail or by letter. This term will start on the day the family member loses the occupational health insurance policy benefit (for example the divorce date).

What are the rate conditions?

The conditions of the individual contract will be the same as those of the individual contracts in force with the insurance company at the time of the individual continuation. The offered cover will be at least similar to the cover of the occupational health insurance policy. The rate conditions will be the same as those in force at the time of the end of the occupational health insurance policy benefit. The individual contract will start as soon as the occupational health insurance policy benefit ends. In principle, the insurer cannot cancel the individual contract.

Pre-financing

What is pre-financing?

The premiums of individual insurance policies are usually slightly more expensive than the premiums of an occupational health insurance agreement. The Belgian health insurance Act therefore provides for a pre-financing system. You can pay an additional premium individually to ensure that the premium for any individual continuation will be the same as the premium you paid at the age when you started the pre-financing. This is done in a separate contract, also referred to as a waiting policy.

More information is available on our website: www.wachtpolis.be.