Are Own Occupation and Specialty Specific the Same for Individual Disability Insurance Policies?
Jul 14, 2010
Jamie Fleischner

Jamie Fleischner

14 Jul, 2010

The most important part of an individual disability insurance contract is the definition of disability. This is the determining factor for the company to decide whether or not to pay a claim. Without a strong definition, you may not qualify for benefits when you need them the most.

Contract language can be very confusing and each company has slightly different names. For instance, some companies call the definition “own occupation” whereas another company calls it “regular occupation” and both have identical definitions.

Instead of only looking at the name of the definition, read the fine print. The most liberal definition will cover you if you can’t work in your occupation. This includes physicians working in a medical specialty. Some companies have specific language to address medical and dental specialties and some don’t. However, if the clause states it will cover you in your occupation, it would deem your medical specialty you were practicing at the time of claim to be your occupation. For instance, if you are an anesthesiologist and hurt your hands and can’t work, you would be able to file a claim because you couldn’t work in your occupation. Even if you were to then go on and do medical research, the policy would continue to pay your benefits as long as you couldn’t do the work you were doing (in this example anesthesiology) at the time of claim.

If you are a physician and changes specialties or do a fellowship in a sub-specialty, you do not need to change your contract. The company would cover you in the medical specialty you were working in at the time of claim.

For more information about policy definitions, contact the Set for Life Insurance office today.

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