14.1.1 "OCC" and "ACC"
Occupational vs. Nonoccupational Coverage
Some people work in occupations that are considered to be hazardous and dangerous. In these occupations, insurers are usually reluctant to provide disability coverage for occupational risks. In that case a nonoccupational policy will be written that covers disabling injuries that occur off-the-job. These policies are usually less expensive, encouraging insureds to select this coverage. In these cases, they are relying on employer-provided workers' compensation benefits to cover them if they are injured on the job.
Occupational policies are sought for disability benefits for both job-related and non-job-related injuries. Off-the-job injuries can be covered by either an occupational or nonoccupational policy.
Disability Defined
Insurance companies take the disability definition a step further and break disability classifications down to the insured's own occupation or any occupation. The interpretation is dependent upon whether the individual is unable to perform the job he/she was performing before the disability or illness occurred or for which the individual is suited by education, training and experience (occ), or if the disabled person is unable to perform any type of work (acc).
For example, if a surgeon loses a hand, he may not be able to perform surgery. If the surgeon has an "own occupation" policy, he would be covered, even though he would still be able to work as a doctor in a nonsurgical field. With the second definition, the inability to perform any occupation (acc), there would be no recovery because the surgeon is still capable of performing some active occupation.
Some policies will pay for the costs of education or occupational rehabilitation for retraining purposes. Some policies adjust the benefits paid to take into account any Social Security payments. The definition of total disability has yet to be standardized. However, almost all disability policies limit or refuse coverage for disabilities caused by attempted suicide, drug addiction or alcoholism. This definition also varies from policy to policy according to "acc" or "occ."
Now do you see why the difference between the two is so important?
