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be certain that the life insured will never again be able to do his work as stipulated in the contract,
before the lump sum is paid out.
In the case of disability income benefits, the disability does not necessarily have to be
permanent. The insurer will pay out the income benefits for as long as the life insured is unable to
fulfil his occupational demands as stipulated in the contract.
It follows from this that the probability of qualifying for disability income benefits are better than for
lump sum benefits.
In order to improve his chances of qualifying for disability benefits, the life insured can choose to
be covered for the specific occupation he is practising at the time of the disability event (regular
occupation). On the other hand, he can choose to pay a lower premium and be insured for regular
and reasonable alternative occupation instead. Once again it is much harder to qualify for the
regular and reasonable alternative occupation benefit, than for the regular occupation benefit,
because the insurer may refuse to admit a disability claim for the latter benefit if the life insured is
still able to fulfil the occupational demands of any alternative job that his training and experience
could reasonably qualify him for.
Remember: disability is the alteration of one’s capability to meet personal, social or occupational
demands due to an impairment, and is assessed by non-medical means (LOA definition of
disability)
No-one that still has to work for an income can afford to be without disability cover, as your ability
to earn an income is your biggest asset in life (provided you are not too old to qualify).
Impairment cover
A lump sum benefit that falls somewhere in between disability, dread disease and accident cover.
It does not cover your ability to fulfil any occupational demands; it covers your ability to function
normally after injury or illness. When assessing your claim the insurer will measure your ability to
function normally against the criteria as stipulated in your contract, and not against your ability to
do your job. Your contract will stipulate a list of qualifying conditions, as well as the degree of
severity of such conditions. It also denotes clearly what percentage of the cover amount will be
paid out in event of a qualifying claim.
One strict condition for payment of an impairment claim is that the impairment has to be
permanent. For this reason, the insurer has to be satisfied that the claimant has already undergone
all the treatment he could reasonably be expected to, and that he has already recovered as far as