The APH Team reviews Income Protection Activities of Daily Living definition
Income protection is designed to protect your income if you become unable to work due to an accident or illness. The policy is designed to pay a tax free amount every month until you are able to return to work or the policy expires, whichever comes first.
Sadly there are different types of income protection policies because they are underwritten using different types of definitions. Today we are reviewing the definition, activities of daily living, also known as work tasks and ADL.
Work tasks or ADL policies are primarily aimed at consumers who insurers deem too ‘risky’ for an own-occupation policies. Typically insurers would deem manual labourers or people who do not have a defined occupation, such as those who care for children at home as high risk, with some insurers selling up to 40 per cent of income-protection policies based on work-tasks based.
Prior to 2013, most UK insurers selling protection insurance sold policies with ‘ADL’ based definition, but following the successful Angry Policyholder campaign against ‘useless definitions’ – specifically ADL’s – backed by industry experts, UK insurers, the media and press most insurers stopped selling them.
Even though this is the case in 2014, you should still be very careful when buying protection insurance to ensure what definition the policy is based on. Most insurers use between 6-8 definitions in their activities of daily living policies (ADL) or work tasks definitions, with you being unable to perform 2-3 to be able to make a claim. Below are six examples:
- Walk 200 metres on a level surface without stopping or suffering severe pain, with the assistance of others or aids
- Lift a 1kg weight from table height and carry 5 metres with the assistance of others or aids
- Be able to communicate in a way to be understood, with the assistance of others or aids
- Read 16 point print, with the assistance of others or aids
- Hold a pen, pencil or use a keyboard with either hand or use a keyboard, with the assistance of others or aids
- To be able to hear others speaking at a normal level in a quiet environment, with the assistance of others or aids
Some insurers use the following definitions:
- Bathing: You always need help from someone to get in and out of the bathtub and this person would also need to bathe you because you’re not able to on our own, even with the use of an assistive device like a handheld showerhead or bath brush. Bathing does not include the ability to reach and wash the back or feet.
- Dressing: You always need help from someone to get your clothes on and off because you’re not able to on your own, even with the use of an assistive device like a buttonhook. If reasonable alterations or changes in the clothing you usually wear would enable you to dress without help from another person, you’re not yet able to make a claim.
- Toileting: You always need help from someone to get on and off the toilet because you’re not able to on our own, even with the use of an assistive device like a grab bar, and to take care of any related hygiene because you’re not able to on our own.
- Transferring: You always need help from someone to move in and out of your bed or a chair because you’re not able to on our own, even with the use of an assistive device like a cane or walker.
- Continence: You’re unable to control either your bowel or bladder functions and always need help from someone to take care of any related hygiene when there is an accident, including caring for a catheter or colostomy bag.
- Feeding: You always need help from someone to get food into your body, either through your mouth or through a feeding tube. Needing help to cook or prepare your meal is not the same as needing help with feeding.
Making a claim
Considering the above definitions and the type of tasks you have to be unable to do to make a successful claim is made even more difficult because these policies are so loosely written.
You are bed-bound in hospital for three months, critically ill like I was, yet this type of policy would not pay out.
You are involved in an accident where you loose the sight in your eyes and a major limb and are unable to work due to the severity of your injuries. It will take time to recover and adapt your life to a point where you can return to work. Once again this policy won’t pay out because with crutches you can walk meaning you will only be unable to do one ‘work task’.
You are ninety five percent blind, lose the use of both legs and your ability to speak. Will you now be able to claim? Short answer NO. The insurer could give you a telescope to read 16 point print.You can blink once for yes and twice no, so are able to communicate in a way to be understood.
All the above examples show just how difficult it is to claim on these types of policies and why they should be avoided at all costs. The only time a claim may be paid is if you are in a coma but the chances of that happening are very low.