Permanent total disablement (PTD) cover
This cover is offered under personal accident policies, where the insured is usually offered 100% of the capital sum insured (CSI) in case he is permanently and totally disabled. The disability should be permanent and beyond any reasonable hope of improvement.
However, the definitions of PTD (Permanent total disablement) vary. Some policies define PTD in anatomical terms. For instance loss of both eyes, loss of both arms, loss of both feet, etc., are treated as PTD entitling the insured to 100% CSI under the policy.
Some other policies define PTD in terms of the extent of disability without anatomical description of disability suffered.
👉Definition 1: Permanent total disablement (PTD) is defined as bodily injury, which is the direct cause of permanently, totally and absolutely disabling the person insured from engaging in being occupied with or giving attention to any employment or occupation of any description whatsoever.
👉Definition 2- PTD means the insured is unable to engage in each and every occupation or employment for compensation or profit for which he is reasonably qualified by education, training or experience for the rest of his life. If at the time of loss he is unemployed, Permanent Total Disability shall mean the total and Permanent inability to perform all of the usual and customary duties and activities of a person of like age and sex.
The definition 1 describes PTD as a disability that renders him incapable of engaging in any occupation at all. This effectively means full physical disability, confined to bed or requiring assistance of someone to take care of oneself.
However, definition 2 examines disability from the standpoint of the insured person and his education, training or experience.
Therefore if a truck driver meets with an accident and his right leg is amputated, as per definition 1, the insurer can say he may not be able to drive but can still sell lottery tickets for a living.😊 So he is not eligible for PTD claim.
However, as per definition 2, he is entitled to PTD. So definition 2 is more favorable to the insured than definition 1.
Careful attention must be paid to policy definitions. Not all PA policies operate in the same manner at the time of claims.
