Income Protection Insurance and Capability Clause
As an insurance policy that covers policyholders who get incapacitated and become incapable to work, income protection insurance has particular terms and conditions that may be deemed unique to such an insurance product. It is always advisable to learn more about a specific income protection insurance policy before deciding to purchase it. This is to make sure you would be properly insured and you would not end up being sorry because of a wrong decision when you chose your policy or an insurance firm.
Among the most important and specific provisions of income protection insurance products are those that are categorized under capability clause. In some cases, capability clauses are included in partial disability provisions. You should read the policy document very carefully to know and fully understand the content of such clauses as they are very significant.
Capability clause would dictate how possible claims would be treated when the policyholder gets incapacitated. The insurance firm naturally and logically wants to make sure the policyholder is truly incapable to return to work before any payout is provided. Because of this, income protection insurance firms usually require medical opinion proving that the claimant is not capable anymore of undertaking any ‘appropriate work.’ There is also a need to prove that the claimant’s injury or sickness renders him/her inappropriate to return to the same work again.
In general, specific provisions contained in capability clauses may result to possible scenarios. The claimant may be considered as just partially disabled if medical requirements are not met for classification under total disability. The partial benefits may be reduced if the claimant becomes able to work although at below his/her optimum capacity. Lastly, a claimant may be declared partially disabled for a period or while waiting for submission of total disability requirements.