Disability insurance claims departments have reported a few tips to remind us how they would treat a COVID-19 claim:
- Does the insured meet the definition of total disability within their policy?
- Does the insured’s attending physician statements certify the disabling condition?
- Has the insured undergone the appropriate care for the condition that is disabling to them?
- Has the insured met the required waiting period before benefits begin?
When carriers look to define a disability, they look at the restrictions and limitations that are preventing someone from working. If someone has the coronavirus and is restricted from working because it could cause harm to himself or others by spreading the virus, this this would potentially be a valid claim; but payments would not begin until the waiting period is met. This period of time is often called the elimination period.
On the other hand, if an insured is choosing not to work or is not allowed to work per instructions from their employer for fear of giving someone else the coronavirus, that would more than likely not be characterized as a valid disability claim. These instances do not meet the basic requirements of a disability as listed above. Most definitions require an injury or illness preventing someone from working in order to be a valid claim.