Definition of Total Disability

The definition of total disability is one of the most important provisions of a disability insurance policy. It is this provision that describes the circumstances in which a benefit is payable for a total disability.

As a consumer, your focus should be in understanding the concept of each definition and NOT just the names. Many insurance companies market their policies as something that they are not. Understanding the differences and advantages of each will assist you in making the most appropriate decision.

True Own-Occupation Definition: (Most Comprehensive)

Defines total disability as the inability, solely due to injury or illness, to perform the material and substantial duties of your occupation, even if you are employed in another occupation.
*The primary focus is that one can receive full benefits while working outside of his/her regular occupation, so long as continuously unable to work in his/her regular occupation.

Modified Own-Occupation Definition: (Less Comprehensive)

Defines total disability as the inability, solely due to injury or sickness, to perform the material and substantial duties of your occupation and you are not working.
*The primary focus is that one is unable to work in a different occupation while on claim, otherwise benefits will be reduced by any earned income.

Any-Occupation Definition: (Inadequate)

Defines total disability as the inability, solely due to injury or sickness, to perform the material and substantial duties of any occupation for which you are reasonably fitted.
*The primary focus is that one will only receive benefits when unable to work in ANY occupation. This is the most restrictive definition of disability used today and clearly the least favorable.

Medical Specialty Specific: (Medical Professionals Only)

If you have limited your occupation to the performance of the material and substantial duties of a single medical or dental specialty, we will deem that specialty to be your occupation.

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