Maryland Life and Health Insurance License Practice Exam

Claims payable to a Disability Income insured occur due to which of the following circumstances?

1. Partial disability

2. Presumptive disability

3. Temporary disability

4. Continuing work ability

The correct answer is: Presumptive disability

Claims payable to a Disability Income insured occur due to presumptive disability when an individual has been deemed to be totally disabled based on specific medical conditions outlined in their policy. Presumptive disability often applies to severe medical conditions such as loss of sight, loss of limbs, or other serious impairments that automatically qualify the insured for benefits without the need for further proof of disability. This provision acknowledges the significant impact these conditions have on a person's ability to work and earn an income. In the context of other circumstances, while partial and temporary disabilities can certainly result in claims, they typically require a certain assessment and may not guarantee benefits as presumptive disabilities do. Continuing work ability doesn't, by itself, warrant a claim for disability income benefits, as it implies the insured can still perform some job functions, which conflicts with the definition of disability needed to trigger benefits. Thus, presumptive disability stands out as the circumstance that most directly supports the initiation of claims without additional verification of the insured's inability to work.