Total and Permanent Disability (TPD) benefit is one of the specific conditions we cover under our critical illness cover plans. Under the TPD definition, if your client becomes totally and permanently incapacitated we’ll pay out the benefit.

This definition can cover any condition not specifically covered elsewhere under our critical illness cover plans and which results in total and permanent disability. Permanent is defined as “expected to last throughout the insured person’s life, irrespective of when the cover ends or the insured person retires”.

Definitions of disability

The definitions of disability we use depend on the occupation of your client. We use two definitions, either own occupation or Functional Assessment Tests (FATs).

Occupation classes 1 and 2 can choose to take either the own occupation definition or the FATs definition.

Occupation classes 3 and 4, Housepersons, students, the retired and the unemployed can only have the FATs definition.

Own Occupation

Under this definition, the plan will pay out if your client is totally unable to follow their own occupation due to illness or an accident, and in our opinion, this is likely to be a permanent situation.

Your client will be assessed on the occupation they were following immediately before the onset of their disability. However, if they are not in gainful employment at the time of a claim, then the claim will be assessed under the FATs definition.

Functional Assessment Tests definition (FATs)

This definition applies to all other occupation classes, to those not in gainful employment and those in occupation classes 1 and 2 who don’t choose to take the own occupation definition. Under this definition, the plan will pay out if, due to an accident or illness, your client suffers an irreversible mental or physical disability which, in the opinion of our Chief Medical Officer, results in your client being permanently unable to carry out at least three of the following Functional Assessment Tests without the help of another person.

These tests include:

• Walking – the ability to walk a distance of 200 metres on flat ground with or without the aid of a walking stick and without stopping or experiencing discomfort.
• Bending – the ability to get into or out of a standard saloon car and the ability to bend or kneel to pick up an object from the floor and straighten up again.
• Communicating – the ability to answer a telephone and to take a message.
• Reading – having the required eyesight (corrected if necessary) to be able to read a daily newspaper.
• Writing – having the physical ability to write legibly using a pen or pencil without aid.
• Climbing – having the ability to climb up a flight of 12 stairs without stopping or suffering severe discomfort.

Joint life plans

For joint life plans, only one definition of disability will apply to both lives if both clients are in gainful employment. This will be shown on their personal illustration.

You can find out more information on TPD in our key features and our product profiles.