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Total disablement and critical illness insurance: Is it included in the cover?

There are critical illness policies that also provide coverage for total and permanent disability. Thus, if the insured gets totally disabled while the policy is in force, he can claim against his policy to help with the expenses now that he is totally disabled and cannot earn an income.

Check to see whether total and permanent disablement is paid in addition to the list of covered critical illnesses or is just a part of the list of critical illnesses. For the first, the insured can claim for both the total disability as well as the critical illness. However, if total disablement is just part of the list of covered critical illness, then the insured can claim only once.

Definitions of Total and Permanent Disablement

When claiming for total disablement, you must check the policy’s definition of total and permanent disablement. There are various definitions that can affect your claim.

  • Own occupation. This means that you are unable to perform your own occupation. For instance, if you are a newscaster and contract a macular degenerative disease that makes it impossible for you to read the news, then you can claim against the policy even if you can still perform other jobs.
    By definition, “Own Occupation” total and permanent disability refers to material and substantial duties that are normally performed as part of your occupation and your duties cannot be changed either by you or your employer.

  • Suited Occupation. This refers to material and substantial duties that you cannot perform and are related to any occupation that you are eligible for, due to your educational background, work experience and training.

  • Any Occupation. This refers to disability for any kind of work, regardless of your training or qualifications. When this is the definition of total and permanent disability, it can be very hard to claim, since it will mean that you are really disabled so severely that you can’t perform any kind of work.

For disability, you must be unable to perform at least 3 out of 10 working tasks, also at least 3 out of 10 tasks required of daily living (including eating, walking, toileting and so on).

 

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