PSI Ohio Insurance Practice Exam

How do most disability policies treat a recurrent disability occurring at least 90 days after the first claim?

1. It is treated as a continuation of the previous claim.

2. It must be handled as a new claim requiring a new elimination period.

3. It is automatically covered under the original policy.

4. It will not require any new documentation.

The correct answer is: It must be handled as a new claim requiring a new elimination period.

When a disability policy treats a recurrent disability that occurs at least 90 days after the first claim as requiring a new claim and a new elimination period, it reflects the standard practices in disability insurance. Most policies differentiate between an ongoing disability and a recurrent one that arises after a significant gap, such as the specified 90 days. By structuring it this way, insurance companies ensure that they properly assess the new circumstances surrounding the recurrent disability. The requirement for a new claim and a fresh elimination period allows the insurer to evaluate the claimant's current health status, determine if the previous condition has truly recurred, and assess any changes in benefits that might need to be applied. This approach can help in establishing that the recurrent disability is not merely a continuation of the prior condition, which may have been resolved or improved. It also assists in managing the overall risk and liability of the insurer, ensuring they have the latest and most relevant information to make fair assessments on benefits and coverage.