The Insurance Buying Guide: Presumptive Disability

This benefit usually is considered optional and provides for total disability benefits to be paid if an injury or sickness causes you the total and irrecoverable loss of:

• speech;
• hearing in both ears;
• sight in both eyes; or
• use of bodily limbs (hands, legs, etc.).

So, if you have a stroke and -- as a result -- lose the ability to speak, you have suffered a presumptive disability and would be entitled to total disability benefits for the duration of the benefit period.

Usually, the requirement that you be under the care of a physician is waived due to the nature of presumptive disabilities.

The claims process typically is simplified with presumptive disabilities. Normally, when you have a disability claim, you and an attending physician must complete a claims form periodically -- every month or once a quarter -- for the duration of the claim.

For a presumptive disability claim, there is a single claims form to be completed at the onset of the claim. Due to the severity of the disability, no further claims forms usually are needed.