By Bob Bhayani, Managing Partner of DrDisabilityQuotes.com, A 2022 Platinum WCI Medical School Scholarship Sponsor
It takes years of education, training, and commitment to practice medicine. If you became too sick or injured to work, what would happen? Would your patients have to go elsewhere? How would you earn an income? Would your lifestyle change?
Long-term disability insurance will pay out a monthly benefit if you have an illness or injury that prevents you from working. Just like most insurance products, you hope to never use it, but, as you experience with your own patients, unexpected illnesses or injuries occur.
Currently, the major players with the highest quality disability insurance products for physicians are Guardian, Principal, Ameritas, Standard, and MassMutual. An independent broker, such as DrDisabilityQuotes.com, will send you quotes from each of these carriers and explain the differences.
However, what is the best disability insurance policy for physicians? The best place to start is by understanding how to differentiate between disability insurance riders and definitions. Quotes can be customized to meet your needs. Disability insurance companies offer a wide variety of riders. Please feel free to use the items below as a checklist of the most important riders within a policy.
Important Disability Insurance Riders
Definition of Total Disability—True Own Occupation
Each company will use different terminology for the definition of total disability. You will be considered totally disabled if you are unable to perform the substantial and material duties of your specialty. True Own Occupation will also continue to pay out the full claims even if you are working in another occupation or specialty while disabled.
Keep in mind: a title such as “Medical Own Occupation” or “Own Occupation” does not always mean that it is Specialty, True Own Occupation coverage. It is important to review the language within the policy, as most definitions will reduce your claims if you can, or are, working in another occupation or specialty.
Residual Disability Rider
What will happen if I still work within my specialty but experience a loss of income due to the inability to work full-time or do specific duties? This rider will pay a partial claim if you lose part of your income but are still working within your specialty. This rider is available on all quality disability insurance plans and should always be considered.
Future Increase Rider
This rider allows you to increase your monthly payout in the future without additional medical assessments. When your income increases, you change employers, or you transition out of training, you may need to increase your monthly benefit to cover more of your income. The increase you are eligible for will depend on your annual gross income and if you hold any other long-term disability benefits. This is an extremely important rider to include for medical students, residents, fellows, or any attending physician that expects their income to increase.
Cost of Living Adjustment Rider (COLA)
This would increase the monthly benefit while you are disabled and collecting claims to help adjust your benefits for inflation. The most common COLA rider will increase the benefit by 3% annually while disabled.
Guaranteed Renewable and Non-Cancelable
Guaranteed Renewable prevents the insurance carrier from canceling the plan or changing the definitions as long as you continue paying the premiums. Non-Cancelable locks in your rates and will not allow the insurance carrier to increase your premiums in the future.
It is important to have both Guaranteed Renewable and Non-Cancelable within your policy.
After reviewing your options with an independent broker, the next step is to apply for your customized policy.
Application Underwriting Process
Underwriting is the process an insurance company uses to determine the final terms and conditions of your policy. After selecting which disability insurance policy to apply for, you will need to go through a two- to six-week underwriting process for approval. However, the approval period varies, depending on how long it takes to receive and underwrite (review) the required medical, financial, and occupational information.
How to Consider Your Medical History When Shopping
When you first engage an independent broker, they will have the experience and relationships within these companies to shop your medical history. The riders and features of a policy are extremely important but only if you can qualify for them during the application process. Companies have different medical guidelines, and the approvals will differ specifically to your unique health history. Part of your evaluation of which company has the best disability insurance for your needs will be what coverage you could be approved for.
There are two types of claims: ERISA-based policies vs non-ERISA policies. ERISA disability plans lead to claims being denied far more often. Depending on the type of policy you have, the legal remediation process can be very different. Typically, ERISA claims are adjudicated in federal courts with a judge vs. non-ERISA claims, which can get jury trials. ERISA only allows back benefits (no pain and suffering) and usually doesn’t pay your court costs.
In most fully underwritten policies, at point of claim, you will be requested to provide full financial documentation; i.e., tax returns, W-2s, pay stubs, and employment contracts. Your CPT billing codes 12 months rolling will be looked at to determine if your Specialty Own Occupation is supported by your attending physicians and specialists’ records.
Mainly, a majority of the delays that occur are in securing all detailed medical records and transcripts, as you are relying on your doctor’s office (and a third party like copying services) to get all the records. The more thorough the documentation you provide, the quicker your claim will be approved.
What other disability insurance questions do you have? How did you go about designing your own disability insurance policy? Comment below!
[Editor's Note: Many thanks to DrDisabilityQuotes.com and Bob Bhayani, one of our Platinum Level (contributing $8,000+) Sponsors for the WCI Medical School Scholarship, for helping physicians secure the best DI policies. DrDisabilityQuotes.com is independently owned, managed, and founded on the basic principle of providing independent, unbiased disability insurance planning solutions to physicians, residents, and fellows nationwide, often at discounted rates. Leveraging its decades' worth of relationships with top insurance carriers, it will shop your business with every major insurance carrier to create a True Own Occupation policy with the best possible rates with all applicable discounts. Bob is a long-time advertiser and on our list of Recommended Insurance Agents. This is the third of our five scholarship-sponsored posts for 2022. Thank you for supporting those who support this site and especially the scholarship. All proceeds go to the scholarship winners.]