Disability

Disability, whether caused by illness or accident, is a condition during which a person is declared medically unfit to fulfill his job related tasks and which consequently can seriously affect his capacity to earn an income.

The occurrence of the disability risk is for obvious reasons much higher than the  “Life risk”.

However regarding their cause, both life and disability claims follow the same pattern: more than 90% are illness related, while less than 10% are due to occupational and private life accident.

For insurers, the main concerns about disability cases are the cause, the nature, the estimated duration and the probability of full recovery.

While disability was mainly seen in the past as a physical impairment, statistics indicate that more than 30% of employee absence is now caused by mental health issues (depression and burnout).

These statistics refer to domestic market situations, but not to expatriates and internationally mobile personnel, which insurers consider as a very specific and healthier population segment.

The international insurance rates which apply for expatriates and internationally mobile personnel are therefore lower than domestic market rates, not only for Group Disability but also for Group Life.

A Group Disability Insurance is intended to mitigate the financial consequences of a disability condition by providing an income replacement during the period of incapacity.

Cover can be limited to the severe cases of total and permanent disability, however group policies generally include also provisions for partial and temporary disability.

The insured benefit can be paid as a lump sum but in most cases is disbursed on a monthly or quarterly basis, which remains due till recovery, death or retirement.

Benefits are typically capped by insurers at about 75% of the employee’s current earnings. Such safeguard ensures a meaningful income support while encouraging a timely return to work.

In order to reduce the claims’ frequency and cover pricing, a “waiting period” of minimum 3 months generally applies.

1.  Claims complexity

The assessment of a disability claim is more complex than a death claim. It can be lengthy and protracted, may have long-term implications for insurer and insured employee, and may even become contentious.

We follow each and every disability claim till their settlement as per policy conditions.

2.  Deficient Policy Wording

The provisions and implications regarding “own occupation” versus “any gainful occupation” are often incomplete, providing room for different interpretations.

Also regarding the applicable type of “disability degree” (economical or physiological) and its mode of calculation, policies are often lacking explicit provisions.

Disability benefits require a comprehensive and accurate policy wording in order to avoid uncertainty for employer and employee.

3.  Pricing Disparities

Insurers’ pricing for comparable disability benefits differs significantly.

4.  Long-Standing Policies

Not only Group Life Policies but also many Group Disability Policies receive insufficient attention once initially established.

5. Optimization Potential

A comprehensive and independent review often reveals opportunities to improve contract wording and pricing conditions, without altering your collaboration with the existing insurance provider and broker.