Does Insurance Pay for Onlays?
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This is one of the most common questions I get from people. The answer is absolutely yes. This comes with a caveat. You need to document. I was at a CEREC lecture many years ago led by a respected colleague who said that when your house burns down, the homeowners insurance does not want to see what your house looked like before, or the McMansion that you built after it burned to the ground. The insurance company wants to see pictures of the destruction. They don't want to see the pristine tooth you made, or the beautiful MODL onlay prep you did, or just a two-dimensional PA of a situation, they want to see the destruction. Make sure you get out your camera and take pictures of the active decay and the undermined cusps. See pics below.
Also, make sure that you print this out on real nice photo paper, and make lots of arrows and notes to the areas you want to highlight. Things like deep crack lines and thin remaining cusps with no dentin support. Make notes on this in bold letters with big arrows showing exactly what you are describing.
If you take the time to do this, you will be surprised at how willing insurance companies will be to reimburse you for your effort.