There are principally three different categories of Total and Permanent Disability Benefit: Own Occupation, Any Occupation and Activities of Daily Living. The highest level benefit available is Own Occupation Career Specific and therefore is capped by whole of market capacity by all product providers and reassurors. Whole of market capacity is the maximum Sum Assured providers and reassurors are able to underwrite on any one individual (irrespective of deal size).
Own Occupation is the highest level of disability benefit normally available for corporate business only (not personal protection). The benefit is paid in the event of total and permanent disability where the Life Assured is unable to do the material and substantial duties of their own specific occupation as a result of accident, disability or sickness and is not following any other occupation at the time of the claim i.e. specific to own occupation. Thus once the total and permanent disability claim has completed, an executive could return to work in a lower capacity.
Any Occupation – this category of benefit is not at the high level of Own Occupation Total and Permanent Disability. It is categorised as the life assured being unable to do their own occupation and unable to do all other occupations to which they are reasonable suited by education, training and experience as a result of an accident, disability or sickness.
Activities of Daily Living – this is categorised as meaning the Life Assured being able to look after themselves and work tasks. They are deemed as being incapacitated if they are unable to perform three or more of the following activities / work tasks, or if they satisfy either the Mental Incapacity of Mental Ill-health definitions:
- Washing. Their ability to shower or bath (stepping into and out of shower or bath).
- Getting dressed and undressed.
- Maintaining personal hygiene, mobility being able to move from room to room.
- Getting out of bed.
- Walking – the ability to walk a distance of 200 metres on a level surface without stopping due to breathlessness, angina or sever discomfort and without the assistance of another person, but including the use of appropriate aids, i.e. walking stick.
- Climbing - the ability to walk up and down a flight of 12 stairs with the use of a handrail and without taking a rest.
- Bending - the ability to bend or kneel to touch the floor and straighten up again.
- Lifting the ability to pick up an object (usually) 2kg at table height and 60 for 60 seconds.
- Getting in and out of a standard saloon car.
- Writing. The manual dexterity to write legibly using a pen or pencil, or type using a desktop or personal keyboard.
- Communicating – the ability to:
(a) clearly hear (without hearing aid or other aid if normally used) conversational speak in a quiet room, or
(b) understand simple messages or
(c ) speak with sufficient clarity to be clearly understood.
- Reading – having eyesight, even after correction by spectacles or contact lenses, sufficient to ready a standard daily newspaper or to pass the standard eyesight test for driving, failure for this activity would include being certified blind or partially sighted by a registered ophthalmologist.
- Dexterity – the physical ability to use hands and fingers, such as being able to communicate effectively using a pen, pencil or keyboard.
- Responsibility and independence – the ability to independently make arrangements to see a doctor and take regular medication as prescribed by a medical practitioner or similarly qualified medical doctor.
- Financial competence – the ability to recognise the transactional value of money and the handling of routine financial transactions such as paying bills or checking change when shopping.