disability · insurance

Disablement

Insurance (general/international)

Definition

The specific event/claim triggering a payout.

Prerequisite chain

Condition. A specific certifying event/claim arises
Functional status. Compensation is triggered
Applied test. Certified only after all reasonable treatments/aids have been tried and failed

Assessment basis (treatment / aids) — Assessed after all reasonable medical treatments and aids have been tried. If aids fail to restore function, disablement is certified.

Qualifiers

Severity. N/A
Duration. N/A
Scope. Permanent Total Disablement (PTD)
Other. Waiting/elimination periods apply

Impact

Triggers financial compensation.

Example

After a 2-year waiting period and exhausting rehabilitation options, an insurer certifies Permanent Total Disablement and pays the lump sum.

Source: General international insurance industry practice

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