South Carolina Life and Health Practice Exam

Presumptive disability allows claims to be payable in which situation?

1. When the insured cannot work at all

2. When the insured can continue to work

3. When the disability is temporary

4. When the disability is self-reported

The correct answer is: When the insured can continue to work

Presumptive disability is a concept used in some disability insurance policies where specific conditions are considered so debilitating that they automatically qualify for benefits, without the need for further evaluation of how the disability affects the insured’s ability to work. This can include situations such as total loss of sight, loss of limbs, or certain other severe conditions. In this context, the correct answer highlights a situation where the insured might still be able to continue working, but the nature of their condition is profound enough to qualify for benefits. This can occur in cases where the insured can maintain some level of employment but is also significantly impaired by their disability. This approach acknowledges that the insured's ability to perform some tasks does not negate the severity of their condition. Therefore, it streamlines the claims process for those with severe, life-altering disabilities that impair their overall quality of life, even if they can still undertake some work duties.