What is Total Permanent Disability on Critical Illness Cover?

I’m going to get Critical Illness Cover but one thing that I would like more information on Total & Permanent Disability protection to help with my research. Can you explain what this is and should I make sure I have it in my policy?

Question asked by Paul James

Total and Permanent Disability is one of around 35 specific medical conditions covered on a critical illness plan. It means that the plan would payout if you are ‘totally and permanently’ unable to work due to sickness or injury. In other words, you were to suffer an irreversible and life changing disability that prevents you from working.

Claims for TDP represent around 3 per cent of all claims on critical illness policies and of those 3 per cent around 55 per cent are rejected for not meeting the definition of being totally and permanent disabled (source: ABI). Payout rates on critical illness plans are usually over 90 per cent with most insurers so this very low payout rate for the TPD section highlights a general lack of consumer understanding as to what TPD actually covers.

Definition of Total Permanent Disability

  • Own Occupation Total Permanent Disability
    TPD can be offered on an ‘own occupation’ basis for low risk workers. This means that the plan could payout if you are totally and permanently unable to work in your own job due to sickness or injury;
  • Suited Occupation Total Permanent Disability
    This means that the plan could payout if you are totally and permanently unable to work due to sickness or injury in an occupation for which you are suited given your skills and experience;
  • Any Occupation Total Permanent Disability
    This means that the plan could payout if you are totally and permanently unable to work due to sickness or injury in any occupation whatsoever;
  • Functional Assessment Tests Definition
    With this definition the plan would payout if you were permanently unable to carry out a number of Functional Assessment Tests without the help of another person (sometimes known as a ‘Work Tasks’ definition).

Naturally, an ‘own occupation’ definition is the most comprehensive form of cover as it means that you would be covered in your exact job.

Examples of TPD Claims

A classic example is if a surgeon was to permanently lose the use of one of his hands, thus preventing him from carrying out operations.

Without TPD cover the surgeon would be unable to make a critical illness claim as none of the other ‘critical illness definitions’ would cover this medical condition. Another example may relate to the development of a psychological disorder such as severe depression, which would not be covered by any other critical illness condition.

With regards to the use of ‘own’ versus ‘any’ occupation, a possible example would be a dancer who had a fall and permanently damaged their back, meaning that they could no longer dance again.

With an own occupation TPD definition they would be covered but with an any occupation definition they would not be covered if they were still well enough to undertake another job.

This is just an example because it is very unlikely that a dancer would be offered own occupation cover in the first place given their high risk job.

TPD – Just One Critical Illness Condition

It is important to note that total and permanent disablement is only one of around 35 conditions covered under a critical illness plan. Other conditions do not relate to whether you are unable to continue working or not, payouts result from the diagnosis of a specific condition.

The vast majority of claims on critical illness policies are for cancer, heart attack and stroke.

Some confusion often relates to becoming paralysed and whether a claim can be made on a critical illness plan and how this relates to TPD. Naturally, if you were to become paralysed you would most likely be unable to continue working on a permanent basis so a TPD claim would normally be valid.

However, a claim would not need to be made under TPD as all leading critical illness plans would cover paralysis as a separate condition (i.e. paralysis is usually one of the 35 conditions covered).

For more information please an article by the Financial Ombudsman Service (FOS).

Need Help?

We started Drewberry because we were tired of being treated like a number and not getting the service we all deserve when it comes to things as important as protecting our health and our finances. Below are just a few reasons why it makes sense to talk to us.

  • There is no fee for our service
  • We are independent and impartial
    Drewberry isn’t tied to any insurance company, so we can provide completely impartial advice to make sure you get the most appropriate policy based solely on your needs.
  • We’ve got bargaining power on our side
    This allows us to negotiate better premiums for you than you going direct yourself.
  • Benefit from our 5-star service
    We pride ourselves on providing a 5-star service, as can be seen from our 3150 and growing independent client reviews rating us at 4.92 / 5.

Very good service from Rauri – he has been very helpful and thorough.

Kathryn Wright
16/05/2021
Reviews.co.uk Logo
Compare Top 10 UK Insurers
Takes approx. 60 seconds
  • £

Or call us on 0208 432 7333

Compare Top UK Insurer Quotes Logos
Contact Us
Head Office & Pensions and Investments
Senator House
85 Queen Victoria Street
London
EC4V 4AB
Personal Insurance & Accounts Payable
Telecom House
125-135 Preston Road
Brighton
BN1 6AF
Drewberry London Office MapDrewberry Brighton Office Map
Our Core Principles
  • 1You Come FirstWe are a client focused business who always aim to put you first.
  • 2We are ExpertsTo provide you with the best advice, we need to know our stuff!
  • 3We are HumanWe are real people with feelings who are here to help you.
  • 4We are ProfessionalProviding a 5-star service requires a professional approach to everything we do.
  • 5We are here to EducateWe don't believe in sales, we are here to educate so you can make informed decisions.
Finalist - Moneyfacts AwardsFinalist - Cover Excellence AwardsHighly Commended - Protection Review Awards
Proud member of AMII (Association of Medical Insurers & Intermediaries)Proud member of Money Advice ServiceProud member of UnbiasedProud member of BIBA (British Insurance Brokers' Association)

If you are unhappy with our service, we have a complaints procedure, details of which are available upon request. If you are unhappy with how your complaint has been dealt with, you may be able to refer your complaint to the Financial Ombudsman Service (FOS). The FOS website is www.financial-ombudsman.org.uk.

Drewberry Ltd is registered in England and Wales. Companies House No. 06675912

Drewberry Ltd registered office: Telecom House, Preston Road, Brighton, England, BN1 6AF. Telephone 0208 432 7333

Drewberry Ltd (Financial Conduct Authority No. 505473) is an Appointed Representative of Quilter Wealth Limited and Quilter Mortgage Planning

Limited, which are authorised and regulated by the Financial Conduct Authority.

Drewberry™ uses cookies to offer you the best experience online. By continuing to use our website you agree to the use of cookies. If you would like to know more about cookies and how to manage them please view our privacycookie policy.