What does “Own Occupation” or “Any Occupation” mean in my LTD policy? Why Have My Benefits Been Cut Off at the Change of Definition Point?

What does “Own Occupation” or “Any Occupation” mean in my LTD policy? Why Have My Benefits Been Cut Off at the Change of Definition Point?

By David Share L.L.B.

President, Share Lawyers, Lawyers

Under most group Long-Term Disability policies, disability payments are made during the initial assessment period if you are unable to perform the essential duties of your “own occupation”. Most often this period is for 24 months (although it differs from one policy to the next). If you have been receiving LTD benefits and are approaching the end of the Own Occupation period, you may face a termination of your benefits based on the change of definition in what constitutes total disability after the own occupation period expires.

The change of definition is usually referred to as a transition from an “own occupation” definition, to an “any occupation” definition. Typically this means that in order to qualify for LTD benefits in the any occupation period, you must be totally or substantially disabled from the duties of any occupation for which you have the requisite education, skills or experience. There are variations on the wording, but this summarizes the typical “Change of Definition”.

You may think that it is impossible, or extremely difficult to persuade your insurance company that you qualify for LTD benefits after this change of definition, but you should not give up hope.   With supportive medical evidence, you may have a strong case to fight against the termination of your LTD benefits based on the “Change of Definition”.

Has your disability insurance claim been denied? Contact Share Lawyers and put our experience to work for you.

All initial consultations with our lawyers are free and there are no fees until we win your case.