The Evolution of Disability Policies Part 6: Definition of Occupation
In Part 6 of our series on how disability insurance policies have evolved, we’ll be taking a look at provisions related to the definition of occupation.
Many older individual disability insurance companies defined “occupation” in a short, relatively straightforward manner. For example:
Your occupation means the occupation you are engaged in immediately preceding the onset of disability.
Since the policy defines occupation as what you are doing immediately before your disability, determining your “occupation” for purposes of your claim requires an assessment of your job and duties at the time you became disabled. This can be a complex evaluation if you have multiple jobs/sources of income or you have changed your schedule/duties.
Newer policies contain additional language and hurdles that can make occupational determinations even more complicated. For example:
Regular Occupation means the occupation of the Insured at the time the insured becomes Disabled . . . . If the Insured is unemployed, retired, or not Gainfully Employed outside of the home for more than 15 hours a week at the start of Disability, the “Regular Occupation” of the Insured consists of the normal daily activities, including household duties, performed by the Insured at the time the Insured becomes Disabled.
This expanded provision could be especially problematic if, for example, you reduced your hours due to a disabling condition but did not file a claim.
Because the definition of “occupation” is so critical to how a disability claim proceeds, it is important for professionals to review their policies and understand how “occupation” is defined, especially before making any changes to work hours or job duties.
Every claim is different, and these are just some examples of how occupation is defined in different policies. Your policy may contain different and/or additional language that could impact your particular situation. If you are unsure about the terms of your policy, or how a provision applies to your specific situation, you should contact an experienced disability insurance attorney.