In most individual LTC policies, how many activities of daily living (ADLs) must the insured typically be unable to perform before benefits begin?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Standard LTC policies define six ADLs — bathing, dressing, eating, toileting, transferring, and continence — and typically require the insured to be unable to perform a specified number of them, most commonly two, in order to trigger benefits. The policy states the exact number and defines what unable means, often requiring substantial assistance from another person. The number required affects both the price of the policy and how readily benefits are triggered: a one-ADL trigger is more liberal and more expensive, while a higher threshold delays eligibility and lowers price. Understanding the ADL trigger is central to counseling clients about when coverage will pay.
Why the other options are wrong
- B) Requiring all six ADLs would make benefits almost impossible to trigger; standard policies require far fewer, typically two.
- C) Four ADLs is a higher threshold than the industry-typical two; requiring four would be an unusually restrictive trigger.
- D) A one-ADL trigger exists only on liberal, higher-priced designs; it is not the standard, and policies define the exact number rather than an absolute rule.
Memory hook
Six ADLs in the basket; typically lose two and the policy starts paying.