Total and Permanent Disability (TPD)

• TPD is a lump sum or monthly benefit (if Family and Personal Income Plan [FPIP] is chosen) which is payable if the insured is totally and permanently unable to work
• The definition of disability can either be own occupation or Functional Assessment Tests (FATs)
• Occupation classes 1 and 2 are automatically given own occupation, although FATs can be selected
• Occupation classes 3, 4 and H01 (housepersons, students, retired and unemployed) are given FATs definition
• Exclusions can be applied, however a maximum of two exclusions per policy can be applied (not per life)

Where one applicant has a FATs definition of disability, both applicants will be given a FATs definition (irrespective of occupation class).

The exception to the above is H01 (housepersons, students, retired and unemployed). Where the other applicant has an own occupation definition of disability, the policy can be underwritten on an own occupation basis because the acceptance letter is worded such that where an applicant is not in gainful employment at the time of a claim a FATs definition will apply.

Introduction

For single life applications, the definition of disability is linked to the applicant’s occupation class.

For joint life applications, please see above. A definition may have to be modified further according to a client's medical history or any other risk they present.

At claims stage the definition of disability will be strictly adhered to and the claim will only be paid if the client fulfills the criteria.

Own Occupation

• Available to occupation classes 1 and 2 only (it is never available to occupation classes 3 and 4)

Definition: “A claim will be met if the life assured is in a gainful occupation immediately before the onset of disability and this happens before the 65th birthday, the policy will pay out if, due to illness or accident, and is totally unable to follow his/her own occupation and in the opinion of Legal & General’s Chief Medical Officer is likely to remain so permanently”.

Functional Assessment Tests (FATs)

• Available to occupation classes 3, 4 and H01
• Occupation classes 1 and 2 can be given FATs definition at underwriting stage if own occupation is declined
• Occupation classes 1 and 2 revert to FATs if they are not in a gainful occupation immediately before the onset of disability

 

Definition: The life assured will be considered totally and permanently disabled if, in the opinion of Legal & General, he/she is unable to perform three or more of the following as a result of illness or accident or disability which has occurred after the policy start date;

• 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 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 stairs without stopping or suffering severe discomfort