South Africa — total, partial, and leftover tasks

The test in this jurisdiction

South African group IP usually pays a monthly benefit if, after the waiting period, you cannot perform the material and substantial duties of your own occupation with reasonable continuity (initial period, often 12 or 24 months). Later the test may shift to any or suited occupation. ‘Partial’ on a lump-sum disability rider is often a scheduled percentage of impairment or occupational incapacity (see NFO CR276) — a different product from IP residual.

The NFO has repeatedly refused to treat leftover or substituted work as the occupation. CR72: part-time clerical leftovers are not a worthwhile, regular performance of material duties. CR259: employing others to do the labour while the business continues can still be total. CR276: a token second job is residual income, not attorney duties. Light duties and ‘still a director’ need a duty list.

Some group contracts have an explicit partial / proportionate income benefit when you return at reduced earnings. If they do not, the insurer may argue that any work ends total — that is a wording fight, not a medical one. Waiting period, offsets (including other disability income), and employer boarding are separate clocks.

Limbs to check

1. Own-occupation total Cannot perform material and substantial duties of the job you actually did, with reasonable continuity — not ‘any desk work’.
2. Leftover tasks Would an employer pay more than a nominal amount for this as the real job, regularly? If not, it is usually still total (CR72), unless the wording has a residual clause.
3. Partial / proportionate Only if the policy names it. Then capture pre-disability versus current earnings. Lump-sum ‘partial permanent incapacity’ is a percentage assessment, not an IP formula.
4. Threshold shift Initial own occupation may later become any / suited occupation. Date that shift. A graded return in month 14 can be judged on a harder test than month 3.