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Know-It-All: Own Occ vs. Regular Occ
January 25, 2019
Which definition of disability is right for which clients? Regular Occupation or the Own Occupation Rider? That often depends on whether they're in a specialized profession. Platinum Advantage offers the flexibility to tailor protection for each client. Use these tips to offer expert advice that can make a difference at claim time.
Regular Occupation — Focuses on Strong, Built-In Protection
First, let's look at the base Platinum Advantage policy language. Total Disability means that due to injury or sickness, your clients meet three criteria. They must be:
- Unable to perform the substantial and material duties of their regular occupation
- Not engaged in any other job or occupation for wage or profit
- Under the regular care of a physician appropriate for their injury or sickness
If your clients become disabled, their current occupation(s) at the time of disability will be considered their Regular Occupation. It's smart to discuss their career plans and anticipate whether they may want Own Occupation protection based on a pending specialty.
Own Occupation Rider — Offers Future Flexibility
Available to occupation classes 3A/3P and higher, this rider changes the policy's definition of Total Disability. It removes the second requirement: “You're not engaged in any other job or occupation for wage or profit.” With the Own Occupation Rider, your clients could work in another job or specialty and still be considered totally disabled — and may qualify for full monthly benefits.
Protection for Specialties — Medical, Dental or Legal
Both the Regular Occupation definition and Own Occupation Rider include specialty language for physicians and dentists. Under the Regular Occupation definition, physicians or dentists will be considered totally disabled if they've limited their practice to a single, recognized specialty and can't perform that specialty.
However, by adding the Own Occupation Rider to a policy, they'll be able to work in another occupation or specialty and still collect benefits. Under Platinum Advantage, the Own Occupation Rider extends specialty language to trial attorneys as well.
Consider these examples* of what may happen at claim time:
| Client | Policy | Alternate Occ | Benefits |
| Client: Emergency Room Physician | Policy: Platinum Advantage with Own Occ Rider | Alternate Occ: Adjunct Professor at Medical School | Benefits: Continues to receive full monthly total disability benefits while earning income in another occupation |
| Client: Realtor | Policy: Platinum Advantage with Own Occ Rider | Alternate Occ: Consultant for Property Development | Benefits: Continues to receive full monthly total disability benefits while earning income in another occupation |
| Client: Trial Attorney | Policy: Platinum Advantage; built-in Regular Occ definition of disability | Alternate Occ: In-House Counsel | Benefits: Received benefits under the Regular Occupation definition until he returned to work in another occupation |
* Examples are based on Platinum Advantage coverage and benefits. They are for illustration purposes only and may not reflect actual claim experiences.
Want to help your clients understand the different definitions of disability? Share our Consumer Brochure.
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