Page 137 - Group Insurance and Retirement Benefit IC 83 E- Book

Definition of Disability

Group LTD policies often use a dual definition of total disability. The "own occupation"

definition probably applies for a period ranging from one to five years, with 24 or 36
months the most commonly used time. If the insured is still disabled after the stipulated

period, the "own occupation" definition Is then replaced with the "any occupation"
definition. This requires the insured to be unable to engage in any gainful employment

for which he or she is reasonably suited by training, education or experience.

Some group LTD policies include a presumptive disability benefit that is paid when the

insured suffers loss of limb or eyesight. The elimination period is typically waived for
presumptive disability and monthly benefits begin at once.

Benefit Coordination

Avery few group LTD policies provide coverage for both occupational and non-
occupational injury and sickness, rather than just non-occupational disability. Even so,

the benefits must be coordinated with any other DI benefits from programs such as
workers compensation.

Additionally, group LTD benefits will always be coordinated with any other potential or

existing DI benefits such as Social Security, state cash sickness temporary benefits or

other government-sponsored benefits. Other possibilities include any STD or sick pay
plan the employer provides, pension benefits that might be available earlier than

retirement age because of the disability, and any individual disability income policies the
individual owns.

Survivor Benefits

Some group LTD policies pay survivor benefits when a disabled insured dies after having

received DI benefits from the policy. Typically, the survivor benefit is paid only if the

deceased received benefits for a certain length of time, such as six months. The LTD
policy specifies who are ―survivors‖ for purposes of receiving the benefit. Survivors