Disability
Policy-defined inability to meet the insured disability test — not a medical opinion.
Ladder step 4: What the policy pays on — Which policy test applies at your claim stage?
This is
- Defined in policy wording — own occupation , any occupation , partial, etc.
- What the insurer must decide
This is not
- Whatever a doctor wrote on a certificate
- A universal medical status
ClaimBuddy resources
Cross-links to Clinical Atlas, glossary, traps, and policy terms — hover for a quick summary.
How do you know?
Practical signs that this term applies to your situation — not legal advice.
- You meet the specific test in your policy — own occupation, suited occupation, or any occupation.
- Functional evidence shows material duties are impossible for the required duration.
- The insurer accepts (or you dispute) their assessment that the policy definition is met.
What triggers it?
Events or thresholds that typically activate this concept in a claim.
- Incapacity continuing through the waiting period without recovery gaps.
- Claim submitted with medical + duty-impact evidence after waiting period.
- Initial Period own-occupation test — may shift to any/suitable occupation later.
- Partial/residual clause if you still earn but below pre-disability level.
Check yourself
Highlighted words link to language-map explainers.
- Which disability test applies today — own occupation or any occupation ?
- Has the Initial Period ended, changing the test?
- Am I totally unable to work, or partially disabled with reduced earnings?
- Is the insurer arguing diagnosis severity instead of duty impact ?
How this links to other terms
Incapacity is the ongoing state; disability is the policy outcome if tests are met.
A certificate diagnosis does not automatically trigger disability.
Initial Period usually applies the own-occupation disability test.
Duty-impact evidence is how you demonstrate disability under own-occupation policies.
Residual clauses pay proportionate benefits if some work continues.
Benefits usually start only once waiting period and disability test align.
Medical impairment ratings use a different scale than policy disability.
Evidence
Policy clause, functional-duty proof, insurer assessment file
Often mixed with
Confusion drill-downs
Side-by-side guides for pairs people mix up with Disability.
Policy may require inability to perform material duties of own occupation for 6+ months.