We have two definitions of disability which apply to Total Permanent Disability and Premium Protection.
We want to offer an ‘Own Occupation’ definition to your clients in as many cases as possible.
To allow us to do this, certain types of occupation will have a small loading applied to Total Permanent Disability (TPD) only. This won’t be reflected in your initial quote and will only be advised once underwriting has been completed. This will not apply to the Premium Protection benefit.
Where we can’t offer Own Occupation, we’ll consider offering Activities of Daily Work (ADW). The definition of ADW means loss of the physical ability through illness or injury to perform at least 3 of the 6 work tasks listed in the key notes section below.
If your client has a high risk occupation we would exclude TPD from the core critical illness conditions and decline the premium protection benefit.
The table below highlights the different occupation risk categories and the definition of disability that would apply:
||Accountant, actuary, admin clerk, architect, bank staff, civil servant, computer programmer, clerical assistant, estate agent, financial adviser, loss adjuster, office worker, receptionist, solicitor, systems analyst, underwriter
|Limited manual content
||Beautician, catering assistant, chef, doctor, hairdresser, photographer, psychiatrist, sales assistant, social worker, undertaker, waiter
|Light manual occupations
||Own with small loading
||Air traffic controller, baker, butcher, car mechanic, care worker, dentist, factory worker, housekeeper, nurse, plumber, postman, security guard, surgeon, teacher, tyre fitter, valeter, vet
||Builder, bus driver, cleaner, fireman, HGV driver, joiner, machine operator, nursery nurse, paramedic, policeman, taxi driver, van driver, warehouse worker
||Farm labourer, fruit picker, market trader, refuse collector, road sweeper, roofer, scaffolder, sports professional, steeplejack
||House persons, retired, student, unemployed, voluntary worker
To check your client's occupation to see if TPD and Premium Protection are available and the definition that would apply, use our definition of disability indicator tool.
- All portal and extranet quotes will assume Own Occupation to produce the quote
- The definition that is applied will be confirmed in the policy schedule
- If TPD is on an Own Occupation basis then the maximum amount payable on claim is £1,500,000 for personal cover, £2,000,000 for business cover and £2,500,000 if your client has a combination of both types of cover. This maximum will apply across all policies held in the market place regardless of the overall sum assured
- TPD acceptance will also be subject to underwriting using medical disclosures which could also change the definition applied.
Own Occupation definition
- Own Occupation means the loss of the physical or mental ability, through an illness or injury, to the extent that your client is unable to do the material and substantial duties of their Own Occupation ever again
- The material and substantial duties are those that are normally required for, and/or form a significant and integral part of, the performance of their Own Occupation that cannot reasonably be omitted or modified
- Own Occupation means the trade, profession or type of work your client does for profit or pay. It is not a specific job with any particular employer and is irrespective of location and availability
- The relevant specialists must reasonably expect that the disability will last throughout your client’s life with no prospect of improvement, irrespective of when the cover ends or the insured person expects to retire
- For the above definition, disabilities for which the relevant specialists cannot give a clear prognosis are not covered.
Activities of Daily Work definition
- Walking – the ability to walk more than 200 metres on a level surface
- Climbing – the ability to climb up a flight of 12 stairs and down again, using the handrail if needed
- Lifting – the ability to pick up an object weighing 2kg at table height and hold for 60 seconds before replacing the object on the table
- Bending – the ability to bend or kneel to touch the floor and straighten up again
- Getting in and out of a car – the ability to get into a standard saloon car, and out again including being able to unlock and operate the door latches
- Writing – the manual dexterity to write legibly using a pen or pencil, or type using a desktop personal computer keyboard.
The relevant specialists must reasonably expect that the disability will last throughout your client’s life with no prospect of improvement, irrespective of when the cover ends or the person covered expects to retire. The person covered must need the help or supervision of another person and be unable to perform the task on their own, even with the use of special equipment routinely available to help and having taken any appropriate prescribed medication.
For the above definition, disabilities for which the relevant specialists cannot give a clear prognosis are not covered.