Split definition coverage is a type of long term disability insurance policy that uses two different definitions of disability to determine whether an insured individual is eligible for benefits. The first definition is an “own occupation” definition, which defines disability as the inability to perform the material duties of one’s own occupation. The second definition is an “any occupation” definition, which defines disability as the inability to perform the material duties of any occupation for which the insured individual is reasonably qualified based on education, training, or experience.
Under a split definition coverage policy, an insured individual may be eligible to receive benefits under the “own occupation” definition for a period of time, typically ranging from one to five years, if they are unable to perform the material duties of their own occupation. After this period of time, the definition of disability may change to the “any occupation” definition, and the insured individual may need to show that they are unable to perform the material duties of any occupation for which they are reasonably qualified in order to continue receiving benefits.
Split definition coverage can provide a more comprehensive definition of disability and may offer greater protection to insured individuals who work in highly specialized or technical occupations. However, it is important to carefully review the terms and conditions of a split definition coverage policy and to understand the transition from the “own occupation” definition to the “any occupation” definition, as this transition may affect the insured individual’s eligibility for benefits.