“Any Occupation” Definition in Disability Insurance Claims

A typical disability insurance policy defines “Any Occupation” as follows: “any occupation that you are or become qualified for by education, training or experience.”

Under most disability policies, the “Any Occupation” definition does not kick in until after benefits have been paid for 2 years, or 24 months. Once disability benefits have been payable for 24 months, the insured is considered disabled only if he or she meets the “Any Occupation” definition. Life Insurance Company of North America, or LINA, has such an “Any Occ” provision in some (or most) of its policies. Under this standard, an insured is disabled if “after Disability Benefits have been payable for 24 months, he or she is unable to perform the material duties of any occupation for which he or she may reasonably become qualified based on education, training or experience which provides him or her with substantially the same earning capacity as his or her former earning capacity prior to the start of his or her disability.”

This standard is somewhat similar to the standard Social Security uses in disability claims and generally requires a greater degree of impairment to continue benefits.

Type of modified occupation language after a set period is called a Change in Definition feature (“CID”). Most policies have a 24 month period, but others may have a 12, 36 or 48 months period before the change to “any occupation.”

The impact of the CID is to require a greater severity of disability to remain disabled and eligible for benefits after the “own occupation” period. Benefits will only continue if the insured satisfies the “any occupation” definition of disability follows the “own occupation” period.

Because there is a change in terminology, this is naturally a point where many insurance companies terminate, or cease, benefits. If you have received notification that your benefits are to cease or be terminated, you should contact The Ortiz Law Firm to assist you in appealing the cut-off of benefits.

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