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Own Occupation Coverage

Own Occupation Coverage

What is occupation disability insurance? What are my options?

What would happen if sickness or injury prevented you from performing the important duties of your occupation?

An Own Occupation disability insurance policy is designed to pay you income benefits just for this reason.

  • Own occupation provisions vary from company to company.
  • They are not all the same.
  • They also vary based upon your occupational duties.

In other words, a company may offer one own occupation provision for Medical Doctors, and a different provision for Dentists. One provision may be offered to Executives and another provision to a Small Business Owner.

Here is a sample of own-occupation clauses available:

Traditional Own Occupation Coverage to Age 65
We will consider you totally disabled if a sickness or injury, in and of itself, prevents you from performing the material and substantial duties of your occupation. Your occupation means your occupation or occupations at the time disability began.

Specialty Own Occupation Coverage to Age 65 (for Physicians)
We will consider you totally disabled if due to sickness or injury, you are unable to engage in your specialty of Medicine provided that was your specialty immediately prior to your disability. If total disability benefits are payable under your policy, the fact that you could work in some other occupation or specialty would not preclude you from receiving benefits during the own occupation period stated in your policy.

Modified Own Occupation Coverage to Age 65
We will consider you totally disabled if a sickness or injury, in and of itself, prevents you from performing the material and substantial duties or your occupation and you are not engaged in any occupation for wage or profit. Your occupation means your occupation or occupations at the time disability began.

60 Month Own Occupation Coverage, then any reasonable occupation
We will consider you totally disabled if a sickness or injury, in and of itself, prevents you from performing the material and substantial duties or your occupation. For the first 60 months of Monthly Income Benefits, your occupation means your occupation or occupations at the time disability began. However, after you have received 60 months of Monthly Income benefits due to the same disability, your occupation then means any reasonable occupation.

60 Month Modified Own Occupation Coverage, then any reasonable occupation
We will consider you totally disabled if a sickness or injury, in and of itself, prevents you from performing the material and substantial duties or your occupation and you are not engaged in any occupation for wage or profit. For the first 60 months of Monthly Income Benefits, your occupation means your occupation or occupations at the time disability began. However, after you have received 60 months of Monthly Income benefits due to the same disability, your occupation then means any reasonable occupation.

24 Month Own Occupation Coverage, then any reasonable
We will consider you totally disabled if a sickness or injury, in and of itself, prevents you from performing the material and substantial duties or your occupation. For the first 24 months of Monthly Income Benefits, your occupation means your occupation or occupations at the time disability began. However, after you have received 24 months of Monthly Income benefits due to the same disability, your occupation then means any reasonable occupation.

Note about Reasonable Occupation
Reasonable occupation is any occupation you are able to do based on your education, training and experience.

Other Common Requirements to Collect Disability Benefits
In order to consider you disabled, you must be under the regular care and treatment of a physician appropriate for the condition causing disability. If in our opinion, continued medical treatment will not improve your condition, we will waive this requirement.

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