Activities of Daily Living (“ADLs”) are basic activities that you perform daily for self-care and independent living at home or in a community. In detail, they include dressing, feeding, mobility (moving around), transferring, toileting and washing. Many insurers and national schemes use these six activities to determine your functional ability. If you cannot perform some of these activities, it may portray signs of a loss of independence and the need for additional support. For instance, this could be home modifications (e.g. adding grab bars in the bathroom), assistive devices (e.g. wheelchair), or physical aid (e.g. hiring a caregiver). Under those circumstances, the insurer may also admit a claim under the terms and conditions of its insurance policy. With this in mind, let’s explore the six Activities of Daily Living in Singapore and how they affect your insurance claims.

Table of Contents:

1. Six Activities of Daily Living
2. Long-Term Care
3. Disability Income
4. Total and Permanent Disability (TPD)
5. Critical Illness
6. Questions to Ask Yourself
7. Final Thoughts

One Minute Summary:

• There are six Activities of Daily Living: Dressing, Feeding, Mobility, Transferring, Toileting, and Washing.
• In Singapore, many life and disability income insurance policies use the Activities of Daily Living as one of the key criteria to determine whether a claim is admissible.
• According to the Ministry of Health (2018), one in two Singaporeans who are healthy at age 65 could become severely disabled at some point and require long-term care support.

Part 1: Six Activities of Daily Living

There are six Activities of Daily Living:

Part 1.1: Dressing

Dressing assesses your ability to put on, take off, secure and unfasten clothes on your own. This includes any braces, artificial limbs or surgical appliances, as appropriate. Dressing requires fine motor skills and coordination. As a result, a person with mobility limitations or upper-body impairments may find this task challenging. For example, a person who experiences pain and stiffness in the joints, such as from arthritis, may struggle with putting on a shirt or to zip up the trousers.

Part 1.2: Feeding

Feeding assesses your ability to feed yourself once food is prepared and served. This activity requires hand and arm strength and coordination. For instance, a stroke surviver may be able to hold a spoon but cannot bring food to his mouth safely. Consequently, this increases the risk of choking or malnutrition.

Part 1.3: Mobility (Moving Around)

Mobility assesses your ability to move indoors from room to room on level surfaces. This is one of the most basic signs of independence. If a person needs a wheelchair or another person’s help to move from room to room, this may indicate a mobility limitation.

Part 1.4: Transferring

Transferring assesses your ability to move from a bed to an upright chair or wheelchair and vice versa. If you cannot transfer safely, you may become bed- or chair-bound. For example, age-related degeneration of muscle mass can make it harder to stand or move without falling.

Part 1.5: Toileting

Toileting assesses your ability to maintain a satisfactory level of personal hygiene. It evaluates your ability to use the lavatory or otherwise manage your bowel and bladder functions. In general, toileting involves coordination, mobility and mental awareness. When we fail to address toileting difficulties, the person may feel embarrassed or loss of dignity. Under those circumstances, a caregiver may be needed to help with the catheter or incontinence pad.

Part 1.6: Washing

Washing assesses your ability to wash in the bath or shower or wash satisfactorily by other means. This includes getting into and out of the bath or shower. Generally, washing also requires coordination, mobility and mental awareness. For example, a person may need a caregiver’s help or special equipment to wash properly.

Part 2: Long-Term Care

Part 2.1: ElderShield and CareShield Life

In Singapore, many life and disability income insurance policies use the Activities of Daily Living as one of the key criteria to determine whether a claim is admissible. Let’s start by understanding our national severe disability insurance schemes, ElderShield and CareShield Life.

Launched in 2020, CareShield Life is our nation’s latest severe disability income insurance scheme. This will gradually replace the older ElderShield scheme. To admit a claim under CareShield Life, a MOH-accredited severe disability assessor must ascertain that you are unable to perform three or more Activities of Daily Living. Under those circumstances, you are deemed to be severely disabled, and CareShield Life will issue a monthly cash payout to you. This payout will continue for as long as the severe disability persists.

Part 2.2: Long-Term Care Supplements

In addition to the national long-term care insurance scheme, you may purchase a supplement from private insurers such as Great Eastern Life, Income Insurance, and Singlife. Generally, these supplements provide a more comprehensive disability coverage and a higher payout. For example, Income Insurance’s Care Secure Pro offers a payout in the event that you are mildly disabled, i.e. when you are unable to perform one or more Activities of Daily Living.

Part 3: Disability Income

Disability income insurance provides a monthly income in the event that you are unable to work due to an illness or an accident. At present, both AIA Singapore and Singlife offer such plans. In summary,

• During your working period, disability refers to an inability to perform your own occupation or any occupation.
• During your non-working period, disability refers to the inability to perform three or more Activities of Daily Living.

Part 4: Total and Permanent Disability (TPD)

Total and Permanent Disability is a common benefit in many life insurance policies, and the Activities of Daily Living is one of the three guidelines used to determine whether a TPD claim is admissible. In general, a physician must confirm the following five criteria:

1. You are not a juvenile.
2. The claim event occurs on or after the policy anniversary on or immediately following your 65th birthday.
3. Even with the use of special equipments, you cannot perform at least three Activities of Daily Living.
4. This disability must continue uninterrupted for at least six continuous months; and
5. There is no possibility of improvement from the disability for an indefinite period.

Upon the admission of a claim, the insurer will typically issue a lump-sum cash payout equivalent to the sum insured under the life insurance policy.

Part 5: Critical Illness

Under the Life Insurance Association (LIA) Critical Illness Framework 2024, one of the 37 covered critical illness conditions is Loss of Independent Existence. To admit a claim, the insurer’s approved doctor must confirm the following three criteria:

1. The condition arises from a disease, illness or injury.
2. You are unable to perform at least three of the six Activities of Daily Living, even with aid.
3. This inability has lasted for a continuous period of six months.

“Aided” means using special equipment, device, and/or apparatus and not relying on human help. Meanwhile, non-organic diseases such as neurosis and psychiatric illnesses are excluded

Upon the admission of a claim, the insurer will typically issue a lump sum cash payout that is equivalent to the sum insured under the life insurance policy.

Part 6: Questions to Ask Yourself

Activities of Daily Living play an important role in defining the terms for payout in many types of insurance policies. When reviewing your insurance coverage, consider the following questions:

1. Does your insurance policy adopt the same ADL definition as the Life Insurance Association of Singapore?
2. How many ADLs must you be unable to perform before you can make an insurance claim?
3. Does your insurance policy cover temporary disabilities, or only permanent ones?
4. When does the insurance coverage ends – upon a claim or at a certain age?
5. What are the exclusions that you should know?
6. Who must certify the disability – any doctor or certain appointed specialists?
7. How to submit a claim if the disability occurs outside Singapore?
8. How does the scope of benefits affect the premium rate?

Part 7: Final Thoughts

Many of us take our independence for granted. After all, we have been performing these tasks effortless everyday. However, the reality is that accidents, illnesses, or gradual ageing can erode these abilities.

According to the Ministry of Health in 2018, 1 in 2 Singaporeans who are healthy at age 65 could become severely disabled at some point in their lifetime and require long-term care support. Moreover, there is also an uncertainty about the duration a person remains severely disabled. Although the median duration of disability is four years, 30% of people could remain severely disabled for 10 years or more.

Having the right type and amount of insurance cover can help to defray the costs associated with disability and long-term care. However, this alone is not full picture. Instead, we should also explore how we can enable your family members and you to maintain dignity, safety, and quality of life, even when functional independence is compromised.

First Published: 22 January 2020
Last Updated: 11 November 2025