If the insured person's doctor and KBC Insurance's consulting doctor
continue to disagree about the degree and/or duration of the work
disability, a third, independent doctor can be appointed to rule on
KBC Insurance will only propose doctors who
are qualified to conduct the joint medical assessment. The insured
person may make a counter-proposal, but the proposed doctors will need
to possess the requisite competences.
After approval of
the assignment has been received, an agreement to appoint a third
doctor will be drawn up and sent in triplicate to the insured person
for signing. The independent doctor starts the procedure, sends an
invitation to the various parties and draws up a preliminary report.
Both the insured person's doctor and KBC Insurance's doctor may add
further comments, after which the final report is drawn up.
The decisions set out in the final report are binding for both
parties. Therefore – depending on the decisions – an additional
payment may be made, but it is also possible that an amount can be
claimed back from the insured person.
The fees and any
additional costs of the third doctor will be borne jointly by the
insured person and KBC Insurance, each paying half. The costs depend on
the fees charged by the third, independent doctor and whether or not
additional examinations are required.