Question

Calder is a member of his employer's group insurance, which includes disability coverage. Calder has some questions regarding this policy and its provisions. Which of the following is correct?

a. Calder's disability benefits will cover him from work-related injury or disability
b. A claim made by Calder must satisfy the definition of disability set out in his province's insurance legislation
c. Detailed medical evidence from a physician may be necessary to substantiate a claim
d. Disability insurance provides coverage from disability arising only from physical impairment resulting in the inability to work

Answer 1

Calder's group insurance disability coverage likely includes protection from non-work-related disabilities. He must satisfy the policy's definition of disability and provide detailed medical evidence from a physician. His coverage is not limited to physical impairments but can also include mental and cognitive impairments.

Step-by-step explanation:

Regarding the group insurance policy's disability coverage, Calder's disability benefits may not necessarily cover him from work-related injury or disability as that is typically covered under workman's compensation insurance. Instead, group disability insurance is intended to cover employees when they are unable to work due to an illness or injury that is not work-related.

Calder's claim would indeed need to satisfy the definition of disability as set out in the policy's provisions, which may differ from his province's insurance legislation. Detailed medical evidence from a physician is often required to substantiate a claim for disability benefits, as insurers need to verify the claimant's medical condition and the extent to which it impacts their ability to work.

Regarding the nature of the disability, insurance policies may cover disabilities that arise from both physical and mental impairments. It is not limited to physical impairment alone as mental and cognitive illnesses that result in the inability to work may also be covered.