What is the dual occupation defense? A Case Study
It is not uncommon for physicians to have tangential roles that generate income, apart from their main specialty. But if they become disabled from practicing medicine—will their disability company pay total disability benefits? The answer may depend on how Regular Occupation is defined—and it’s not uncommon for companies to try and use a dual occupation defense to get out of paying full benefits.
One such case is that of Sigillito v. Augustar[1]. Dr. Sigillito worked as an emergency room physician up until he was no longer able to practice, after he developed vision complications from Hashimoto’s disease.
Dr. Sigillito continued to work post-diagnosis for quite some time but eventually limited his practice until he completely stopped working on July 25, 2022. However, by that point he had also been working as an Assistant Parish Coroner since August 16, 2021. Dr. Sigillito filed his disability claim with Augustar on February 2, 2024 and continued working as a coroner until March 24, 2024.
Augustar denied total disability benefits and argued that, at the time of his disability, Dr. Sigillito had two occupations—ER physician and coroner—and was therefore not totally disabled because he had demonstrated that the capacity to continue performing coroner duties.
Dr. Sigillito argued that his policy provided for benefits if he was “not able to perform the substantial and material duties of [his] Regular Profession.” Dr. Sigillito argued his regular profession was solely an ER doctor while Augustar maintained his regular profession encompassed all work duties he was performing immediately prior to his date of disability. To further complicate matters, Dr. Sigillito claimed it was impossible to name an exact date of disability because his condition was slowly degenerative and it affected his work before he stopped completely.
After reviewing the parties’ positions, the court determined that the parties had raised several disputes of material facts that must be resolved at trial (specifically, the scope of Dr. Sigillito’s Regular Occupation, whether he was engaged in one or more occupations at the time of disability, whether his visual impairment prevented him from performing his Regular Occupation, and whether Augustar correctly classified his claim as one for Residual Disability). As of the writing of this post, the case remains pending.
This case highlights the difficulty of establishing total disability when you have more than one source of income—even with a specialty-specific policy. If you feel your insurance company might be trying to employ the dual occupation defense to get out of paying total disability benefits, you should speak with an experienced disability insurance attorney.
Every claim is unique and the discussion above is only a limited summary of the court’s ruling in this case. If you are concerned that your insurer is not evaluating your claim under the proper standard, an experienced disability insurance attorney can help you assess the situation and determine what options, if any, are available.
[1] Robert J. Sigillito V. Augustar Life Assurance Corporation, No. CV 24-2556 (E.D. La. Aug. 20, 2026)
