Category: Claims
Most retail Income Protection policies test 'own occupation' for the first 24 months on claim, then tighten to 'any occupation' for which you are reasonably suited. The disability definition decides whether a claim is paid, so it sits at the centre of every IP contract.
The definitions below all sit within Australian retail IP contracts issued under APRA's October 2021 reforms. Direct (DTC) IP and group salary continuance use different wording. Check your own policy schedule before relying on any general statement.
During the first 24 months of benefit payments, retail panel insurers test whether illness or injury stops you performing the important and substantial duties of your own occupation. You can still claim while doing some lighter work, provided you are not fully capable of your usual role.
After the 24-month mark, most policies switch to an 'any occupation' test. The benefit continues only if you cannot work in any occupation for which you are reasonably suited by education, training, or experience.
Some higher-tier plans hold the own-occupation test for the full benefit period at a premium cost. AIA's IP Advantage and IP PLUS variants document this option (Section 5 footnotes).
A surgeon who loses fine hand control cannot operate (own-occupation disabled) but may still teach (any-occupation capable). For the first 24 months the surgeon claims; after that the surgeon may not. This single switch is the most common reason a long-duration claim ends. Discuss the trade-off with a licensed adviser before you choose a benefit period longer than 2 years.
General advice only. Definitions vary between insurers and policy tiers. Confirm the exact wording against the current PDS of any insurer you are considering.
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