What is ‘any occupation’?
‘Any occupation’ definition of disability states that benefits will only be awarded if an injury or sickness has interfered with the insured’s ability to work in any occupation that they are reasonably qualified for depending on their level of education or previous experience. This test usually becomes a governing test after two years of disability that determine whether the insured still qualifies for benefits.
There are two factors that the courts consider when interpreting this provision for ‘any occupation’. First, the insured’s injuries must be looked at as a whole. This simply means that, if the person is not suffering any physical injuries, it shouldn’t be assumed that he/she is able to return to work by ignoring the emotional and cognitive problems they may be experiencing.
Secondly, the court will look at whether the occupation is something that the insured is reasonably qualified for. For instance, a former CEO cannot be denied benefits because he/she can work as a tele-marketer. The court will consider whether the employment is reasonable by determining the duties, type of job as well as compensation offered compared to the person’s previous work before the disability.
Difference between ‘any occupation’ and ‘own occupation’
If the provision in your policy is an own occupation test, on the other hand, you may qualify for benefits if the injury or sickness directly interferes with your ability to perform a substantial part of your own occupation. This provision is usually the most lenient because it considers the insured’s ability to perform their specific job. Unlike ‘any occupation’ which is more difficult to meet, interpreting the ‘own occupation’ clause is usually clearer.
Why you need legal help
If you have been denied benefits because of failure to pass these tests, it’s important to get independent advice to ensure your rights are fully protected. Insurers are known to terminate benefits unfairly by interpreting ‘any occupation’ too narrowly. The judge will consider other factors when interpreting the ‘any occupation’ provision. For instance, the court will look at the availability of work for the insured, how much compensation they’re likely to be paid as well as their mental wellbeing.
An experienced long-term disability lawyer will work hand in hand with the right medical experts to gather evidence that supports their client’s inability to work. For instance, if you are diagnosed with depression, a qualified psychiatrist may be a more suitable expert witness than a doctor to support your case.