Business Insurance Online :: Articles

Disability Insurance - How it Works

How does disability insurance work for young and healthy individuals?

Disability Insurance - How it Works

The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.

If you work in a sedentary occupation and are young and healthy, insurance and especially disability insurance is probably not at the top of your list of things to investigate. Would you be able to pay your bills should you be out of work for 90 days? Most people look at the odds of something happening to them and discount themselves as part of the statistics but at least 30% of people 35-65 suffer a disability lasting 90 days. It could be broken bones from any number of accidents or a problem pregnancy or any of many possibilities.
If you work in a sedentary occupation and are young and healthy, insurance and especially disability insurance is probably not at the top of your list of things to investigate.

Would you be able to pay your bills should you be out of work for 90 days?

Most people look at the odds of something happening to them and discount themselves as part of the statistics but at least 30% of people 35-65 suffer a disability lasting 90 days.

It could be broken bones from any number of accidents or a problem pregnancy or any of many possibilities.

Disability Insurance was created with the intention of replacing approximately 75-80% of your gross income tax free should you become sick or ill enough that it prevents you from working and earning a living in your occupation.

Most Disability insurance is geared toward white collar occupations.

Blue/Gray collar disability insurance is available through some insurance carriers.

If you are a fireman, policeman or a roofer or any the other occupations considered blue collar you will need to do more research for basic information beyond this site.

Different insurance companies offer disability insurance policies but they are not the same.

Do not assume they are and go for the lowest cost. Do not buy the cheapest disability insurance policy you find.

Doing this would lower your odds of getting paid a monthly benefit and the benefits could be significantly lower than what you would receive from a better contract.

If you are in the initial stages of investigation of such policies know that they are not easy to shop and just compare prices, you need to compare the following to truly get what you need.

Disability insurance policies have a definition of total disability written in the policy.

You should understand this before you buy.

There are three basic types of policies.

* Own Occupation - "Unable to perform duties of your regular occupation." If you are not severely disabled and you can do work in some other occupation you will still be considered totally disabled in your own occupation but you will not be penalized while on claim for working in another occupation.

* Modified own occupation (Income Replacement Insurance) - This is the most common definition in the industry today. "Unable to perform duties of your regular occupation, and are NOT engaged in any other occupation." In other words if you go back to work in some other capacity you will be penalized during a claim. The insurance company MAY offset your monthly benefit check.

* Gainful Occupation - This is the common definition for a policy written for an employer sponsored group.

"Unable to perform duties of your regular occupation, or any occupation for which you are deemed qualified." This definition leaves the determination of your disability up to the insurance company. It is not clear what would happen should you become disabled. Avoid this type of policy if you are buying disability insurance on your own. If you receive it through your employer look into supplementing it with a better policy.

Renewability is another aspect that you should understand when buying a disability policy. Review the following three types available.

* Non-Cancellable and Guaranteed Renewable - Guarantees that after purchasing this policy they will not change your premium schedule, your monthly benefits or your policy benefits to age 65 or whatever age you agreed to. Even if your income goes down later in life and you become totally disabled the insurance company will pay you the total disability benefit you originally placed in force. Even if you changed jobs from a white collar to a more risky occupation later on. As long as you kept your policy in force they can not change anything. This is the best and really only way to go. Make sure the exact words "Non-Cancellable and Guaranteed Renewable" are written into the policy.

* Guaranteed Renewable - This guarantees that they will probably not change anything about the policy, but they can. They can change the policy year, occupation class and the premium with approval from the state. Be very careful of this type of policy.

* Conditionally Renewable - You get no guarantees with this type of policy. Different companies may offer you different conditions for you to renew each year and these conditions may be very hard to meet. Avoid this completely.

Many disability claims involve a residual claim.

This means a person can still perform the duties of their occupation but they have a loss of income of at least 20% or they have suffered what is called a loss of time and duties.

On a loss of time and duties claim they normally stop paying a residual claim once you are back at work full time. But, your income may not be back to what it was before you were disabled.

A residual provision based on loss of income would appear to protect you for an unlimited amount of recovery time. The loss of time and duties portion of a policy may have a recovery benefit portion but may only pay out for a limited time.

A person may be residually disabled longer than totally disabled.

Presumptive disability protects against drastic disabilities that occur. Presumptive disability varies. This covers for loss of sight, hearing, speech, and limbs.

This coverage is built into most contracts but not all. The wording maybe different and they use words like, Total, Irrecoverable and Permanent.

An irrecoverable loss or disability is permanent and that is what they will pay on. Total loss means if you have a total loss and it is permanent it covers you.

Total loss also covers broken bones and temporary loses of sight, hearing, and speech etc. Make sure you understand their meaning.

Recurrent disability is where you recover from one disability and then another one pops up.

There is what the insurance industry calls an "elimination period".

The time you wait between the onset of a disability and when you are eligible to collect benefits.

Most policies are for 14 to 90 days. Recurrent disabilities should have no elimination period.

Look for a policy that has at least a 12 month recurrent clause in case some new problem shows up. Make sure your elimination period can be satisfied with either a total disability or a residual.

Policies that have an elimination period just for total disability or with just consecutive days of disability are not good.

Be sure to find out how long disability benefits will be paid.

This benefit period is from the time you are eligible to collect benefits while on a claim and when you go back to work or if you are permanently disabled it would pay the claim until the "To Age 65" or whatever the age or time frame stated on your insurance policy. To age 65 is the most popular and most disabilities last a little over 3 years.

There are optional riders you can add to a base policy for additional protection.

They may include a Cost of Living Adjustment, Automatic increase rider and other options. There are also exclusions that your insurance agent should discuss with you.

Published: Wednesday, 6th May 2009
Author: 146


Insurance News

Deloitte's 2026 Insurance Predictions: Key Trends Shaping the Future
Deloitte's 2026 Insurance Predictions: Key Trends Shaping the Future
17 Apr 2026: Paige Estritori
As Australia's insurance industry stands on the cusp of significant transformation, Deloitte's latest report, 'Insurance Predictions 2026,' offers a comprehensive analysis of the key trends poised to reshape the sector. The report underscores the imperative for insurers to adapt to rapid technological advancements, escalating climate risks, and evolving regulatory landscapes. - read more
APRA Warns of Heightened Risks in Australia's Insurance Industry
APRA Warns of Heightened Risks in Australia's Insurance Industry
17 Apr 2026: Paige Estritori
The Australian Prudential Regulation Authority (APRA) has recently issued a cautionary statement regarding the elevated risks confronting the nation's insurance sector. This alert underscores the necessity for insurers to bolster their resilience against a backdrop of climate hazards, cyber incidents, and global geopolitical tensions. - read more
Private Health Insurance Premiums Set to Increase by 4.41% in April 2026
Private Health Insurance Premiums Set to Increase by 4.41% in April 2026
17 Apr 2026: Paige Estritori
Australian private health insurance policyholders are set to experience a significant premium increase, with rates rising by an average of 4.41% from April 2026. This adjustment marks the most substantial hike since 2017, reflecting the escalating costs associated with medical and hospital services. - read more
Debate Intensifies Over Proposed Legal Fee Caps in Australian Insurance
Debate Intensifies Over Proposed Legal Fee Caps in Australian Insurance
09 Apr 2026: Paige Estritori
The Australian insurance sector is currently witnessing a significant debate over the Insurance Council of Australia's (ICA) proposal to implement caps on legal fees associated with civil liability claims. This initiative aims to address the rising insurance premiums that have been a concern for small to medium business owners across the nation. - read more
Premium Affordability and Cybersecurity Emerge as Top Challenges for Australian Insurers
Premium Affordability and Cybersecurity Emerge as Top Challenges for Australian Insurers
09 Apr 2026: Paige Estritori
In the dynamic landscape of the Australian insurance industry, a recent survey conducted by Gallagher Bassett has shed light on the primary challenges confronting insurers in 2026. The findings underscore a significant reshaping of priorities, with premium affordability, cybersecurity, and labour shortages emerging as the most pressing concerns. - read more
Business Insurance Articles

Understanding Liability Insurance: Essential Coverage for Your Business
Understanding Liability Insurance: Essential Coverage for Your Business
Liability insurance is a crucial component of a business's risk management strategy. It provides protection against claims resulting from injuries and damages to people or property. Businesses of all sizes face potential risks daily, and this type of coverage is designed to shield businesses from significant financial losses. - read more
Business Interruption Insurance: Why It’s Crucial for Small Business Owners
Business Interruption Insurance: Why It’s Crucial for Small Business Owners
Business interruption insurance is a type of coverage designed to compensate businesses for lost income and operational costs when they are unable to operate due to a covered event such as a natural disaster, fire, or other incidents that disrupt business operations. - read more
Key Factors to Consider When Comparing Business Insurance Options
Key Factors to Consider When Comparing Business Insurance Options
Business insurance is a vital aspect of safeguarding your company's interests and mitigating potential risks. Whether you are a small startup or a well-established organization, having appropriate insurance coverage is essential for protecting your assets, finances, and reputation. - read more
How to Customize Your Business Insurance to Fit Your Company’s Needs
How to Customize Your Business Insurance to Fit Your Company’s Needs
Business insurance is a type of coverage that protects your company from financial losses that may occur during regular operations. These losses could be due to a variety of risks like property damage, legal liability, or employee-related incidents. - read more
Understanding Liability Insurance: A Guide for Small Business Owners
Understanding Liability Insurance: A Guide for Small Business Owners
Liability insurance is a type of coverage that protects businesses from financial losses due to claims of injury, harm, or damages made by third parties. This insurance is crucial for covering legal costs and compensation that might arise from such claims. - read more

Knowledgebase
Insurance broker:
An agent acting on behalf of the insured (not the insurance company) who negotiates the terms and cover provided by the insurer in the insurance policy.