What is taken into consideration when defining total disability in a disability income policy?

• A. Number of days spent in the hospital
• B. The amount of additional coverage the insured has
• C. The insured's education, training and experience
• D. The elimination period

Answer: (C)

Total disability is determined by whether the insured, given their education, training and experience, cannot perform the essential duties of their occupation (or any occupation) as their background would reasonably allow. Because a person’s education and work experience define what kinds of tasks and jobs they’re realistically capable of, disability status hinges on whether those duties can be carried out despite the illness or injury. If the person cannot perform those duties in light of their background, they’re considered totally disabled and eligible for benefits under that definition. The number of days spent in the hospital, the amount of additional coverage, or the elimination period do not itself define total disability; the elimination period is just the waiting time before benefits begin, while hospital days and coverage amount relate to other policy features rather than the disability determination.