There are several definitions of "disability" within a disability insurance policy; therefore, there are several ways you can be disabled under the terms of the policy. A disability is a sickness or injury which interferes with your ability to work and bring home an income. Many people think of "suffering a disability" as a car accident, but the reality is most are illness-related (close to 90%). In a policy, the most common definitions of disability are “total, partial, and presumptive.”
The definition of total disability in Provider Choice is a true own-occupation definition for all occupational classes, unless you choose the "2-year true own-occupation" or "2-year modified own-occupation" options. Total disability, or totally disabled, means that, solely due to injury or sickness, you are not able to perform the material and substantial duties of your occupation or occupations if more than one, in which you are engaged at the time of disability.
Sometimes an illness or injury doesn't cause a total disability but does limit your ability to work, which results in a decreased income. Or, you might suffer a total disability and return to work, but not at your pre-disability earnings. Our Enhanced Partial Disability Benefit rider1 provides benefits when, solely due to injury or sickness, you suffer a loss of income of 15% or more. Benefits are calculated using dollar-for-dollar income replacement for the first 12 months, up to the policy's monthly benefit.2 After that, benefits are paid in proportion to your income loss. If the loss of income is 75% or more, we will consider the loss to be 100%. For individuals who own their own businesses, are in sales, or are the chief rainmaker for their company, we highly recommend an Enhanced Partial Disability Benefit rider on your policy.
Should you suffer the total and complete loss of hearing in both ears, the ability to speak, sight in both eyes, or the entire use of both hands or feet, or one hand and one foot, the insurance company will pay you “first day benefits.” In other words, if you suffer one of those losses, you do not need to wait through the elimination period before you become eligible for monthly benefits. Berkshire's Provider Choice will always consider you to be totally disabled even if you are gainfully employed if injury or sickness results in a presumptive loss.