Cannot get true own-occupation disability, and have no option for guaranteed standard issue. What to do next?

[Please_Stand_By]

So as title says, an individual insurance broker said after a soft inquire that none of the big 6 will cover me. I checked with my university system (still in training) and there is no GSI option. I checked hospitals that I am looking for attending jobs, and it seems none of them have GSI either.

I do worry about the routine employer premium payed group long term disability coverage, and would like some level of extra disability coverage, even if it's something less appealing such as the AMA's version. I did see Northwestern Mutual has options too? After lots of podcast listening, NW Mutual and the AMA seem to be garbage though.

Kind of stuck and hoping for advice- thank you!

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[calvnandhobbs68]

They won't cover you because of a pre-existing condition I'm assuming? I guess you'd have to know why they aren't willing to cover you, although most disability insurances will still cover you with a rider excluding the pre-existing conditions so that's kind of weird.

 

[Please_Stand_By]

They won't cover you because of a pre-existing condition I'm assuming? I guess you'd have to know why they aren't willing to cover you, although most disability insurances will still cover you with a rider excluding the pre-existing conditions so that's kind of weird.

Yup. Mild HTN, high LDL normal TAG, super mild OSA (AHI <6, but never a desat under 89%). Apparently this is a no-no. I should have not sought evaluation for things years ago!

 

[calvnandhobbs68]

Yup. Mild HTN, high LDL normal TAG, super mild OSA (AHI <6, but never a desat under 89%). Apparently this is a no-no. I should have not sought evaluation for things years ago!

Really? That's surprising that probably defines half the middle aged physicians they'd see for disability insurance.

 

[Please_Stand_By]

Really? That's surprising that probably defines half the middle aged physicians they'd see for disability insurance.

Yup, it's crazy. Sigh, well lucky me.

 

[acevmd1616]

Good morning, Hypertension, High Cholesterol and even Sleep Apnea you can get coverage for. Some carriers are more strict on underwriting than others. The issue really comes down to control on the blood related issues and compliance with the sleep apnea. Basically, are you wearing your CPAP routinely as an example.

I can't advise enough about staying away from Northwestern or AMA plans. Nothing worse than thinking you have a "Own Specialty" Disability Policy. You get disabled and find out you don't. Disability should not be death sentence to your medical career.

Same goes for group coverage through your employer. It's not going to be enough. Great plan for a accountant making $100k a year. Not great for physicians who have talents and skills that go well beyond doing procedures and seeing patients.

@Please_Stand_By my advice would be to apply to one of the six carriers. When you speak with the agent I would be up front with your medical history. Some agents will go to one underwriter. If they say no they will stop there. Based on the medical history provided I feel confident you will find a carrier to at least take an application from you. If you do get declined. There is always Lloyd's of London. You can find a policy there that is Own Occupation and would be similar in price to what you would get from the big 6 carriers.

Hope this helps

​

 

[RangerBob]

I'm not sure I'd call NW Mutual garbage. Yes, it’s not the top. Definitely go with one of the other big 4/6 or whatever if you have the chance (which is what I wish I did), but an independent agent I spoke with a year ago referred from WCI blog felt keeping my NML policy probably made more sense. It’s not as good of coverage as the others, but basically the difference is if I’m disabled and choose to go work in another profession, my disability paycheck gets cut a bit. If I don’t work I get full benefits.

I still plan to apply for coverage with the others in the next year or so, but with COVID exacerbating a few things I’m not sure I’ll get a favorable response.

Bottom line is listen to what WCI says and get an own occupation policy with future increase option as a resident, from one of the top companies.

If you do look into NML, treat the agent as a salesperson (ie, take everything with a grain of salt until you see the contract, and assume they’re up selling you). Because they really are more like salesmen.

Can’t comment on AMA policy.

 

[Please_Stand_By]

Good morning, Hypertension, High Cholesterol and even Sleep Apnea you can get coverage for. Some carriers are more strict on underwriting than others. The issue really comes down to control on the blood related issues and compliance with the sleep apnea. Basically, are you wearing your CPAP routinely as an example.

I can't advise enough about staying away from Northwestern or AMA plans. Nothing worse than thinking you have a "Own Specialty" Disability Policy. You get disabled and find out you don't. Disability should not be death sentence to your medical career.

Same goes for group coverage through your employer. It's not going to be enough. Great plan for a accountant making $100k a year. Not great for physicians who have talents and skills that go well beyond doing procedures and seeing patients.

@Please_Stand_By my advice would be to apply to one of the six carriers. When you speak with the agent I would be up front with your medical history. Some agents will go to one underwriter. If they say no they will stop there. Based on the medical history provided I feel confident you will find a carrier to at least take an application from you. If you do get declined. There is always Lloyd's of London. You can find a policy there that is Own Occupation and would be similar in price to what you would get from the big 6 carriers.

Hope this helps

​

Thanks for the message. It is just weird because my BP is ~134-140 systolic without meds, sleep apnea was so borderline that the sleep docs were like we can try CPAP just to see (and it didn't help) so I do not use it. I wonder if I order-sold my medical history to the independent agent (I think I wrote fatigue down too in the PMH box-which was really more sleepiness, which was why I wanted to pursue a home sleep study for my own curiosity).

Would it be worth it to try at a different independent broker? One that instead of just using the big 6, will look into others like Lloyd's? I wonder if other agents do soft inquiries with the big 6 again if that will trigger a red-flag.

 

[RangerBob]

Thanks for the message. It is just weird because my BP is ~134-140 systolic without meds, sleep apnea was so borderline that the sleep docs were like we can try CPAP just to see (and it didn't help) so I do not use it. I wonder if I order-sold my medical history to the independent agent (I think I wrote fatigue down too in the PMH box-which was really more sleepiness, which was why I wanted to pursue a home sleep study for my own curiosity).

Would it be worth it to try at a different independent broker? One that instead of just using the big 6, will look into others like Lloyd's? I wonder if other agents do soft inquiries with the big 6 again if that will trigger a red-flag.

It’s worth trying. It seems weird that they’d all deny you outright, rather than just exclude certain things.

Just be careful-if you apply, it’s probably best to apply to all at once. If you apply one at a time it can hurt you because if you get a denial you have to disclose that on future apps.

If you don’t know who whitecoatinvestor is, go to his website. He has great articles on disability insurance and has links to independent insurance agents who have experience working with physicians. There is a reason WCI is so popular—he gives very helpful advice.

 

[Please_Stand_By]

It’s worth trying. It seems weird that they’d all deny you outright, rather than just exclude certain things.

Just be careful-if you apply, it’s probably best to apply to all at once. If you apply one at a time it can hurt you because if you get a denial you have to disclose that on future apps.

If you don’t know who whitecoatinvestor is, go to his website. He has great articles on disability insurance and has links to independent insurance agents who have experience working with physicians. There is a reason WCI is so popular—he gives very helpful advice.

At this stage what do I have to lose. I may try to find another independent broker and check explaining things, but should I not mentioned I tried elsewhere for a soft application?

 

[RangerBob]

At this stage what do I have to lose. I may try to find another independent broker and check explaining things, but should I not mentioned I tried elsewhere for a soft application?

It may be helpful to let the new broker know what the old broker said.

A soft application (from my understanding of what a soft application is) isn't something you need to disclose to the insurance companies. I think you may need to answer in the actual application if you have previously applied for disability insurance (you'd answer no since you didn't submit an application) and I believe most will ask if you've ever been denied disability insurance (so you answer no there as well).

If by "soft application" you actually did submit an application that your broker had you fill out, where you wrote down your entire medical history, family history, SSN, etc. etc., signed/dated it, etc., then you may need to disclose that. But telling your broker what your medical conditions/age/etc are and having them do an inquiry is not that same as an actual application.

A good broker should be able to guide you and tell you if they think you need to do a shotgun approach with multiple companies, or if you can just fill out the application for one or two.

 

[Please_Stand_By]

It may be helpful to let the new broker know what the old broker said.

A soft application (from my understanding of what a soft application is) isn't something you need to disclose to the insurance companies. I think you may need to answer in the actual application if you have previously applied for disability insurance (you'd answer no since you didn't submit an application) and I believe most will ask if you've ever been denied disability insurance (so you answer no there as well).

If by "soft application" you actually did submit an application that your broker had you fill out, where you wrote down your entire medical history, family history, SSN, etc. etc., signed/dated it, etc., then you may need to disclose that. But telling your broker what your medical conditions/age/etc are and having them do an inquiry is not that same as an actual application.

A good broker should be able to guide you and tell you if they think you need to do a shotgun approach with multiple companies, or if you can just fill out the application for one or two.

Super helpful! I got some cash-only self ordered labs done recently (been doing plant based eating/no alcohol for the last month) to recheck my LDL...hopefully it is close to normal. Then will ask another broker to check again. I just wish I can specify like "borderline HTN", "mild OSA" rather than get grouped in with somebody who has morbid OSA etc.

 

[acevmd1616]

My two cents. Applying to all is not a good idea. The reason being is they all communicate with each other. If you apply to Principal and they see that you have applied to Guardian. They will basically be at a "stalemate" until one finally makes a decision and will want to know what the other is offering.

Definitely, think doing a soft inquiry would be the safe approach. This should not be a application. Just a summary of your mental history submitted anonymously. Keep in mind this is still no guarantee of coverage. Your labs and medical records will obviously tell the story. A denial is not the end of the world. Red flag, sure but not dead in the water as you would think. I've heard plenty of scenarios where Ohio National would deny a case Ameritas would cover.

In terms of brokers. Look for one that sells specifically to physicians. Plenty of them out there. The more information in terms of providing LDL levels etc... will get you a much more accurate answer on the "soft inquiry".

 

[acevmd1616]

I'm not sure I'd call NW Mutual garbage. Yes, it’s not the top. Definitely go with one of the other big 4/6 or whatever if you have the chance (which is what I wish I did), but an independent agent I spoke with a year ago referred from WCI blog felt keeping my NML policy probably made more sense. It’s not as good of coverage as the others, but basically the difference is if I’m disabled and choose to go work in another profession, my disability paycheck gets cut a bit. If I don’t work I get full benefits.

I still plan to apply for coverage with the others in the next year or so, but with COVID exacerbating a few things I’m not sure I’ll get a favorable response.

Bottom line is listen to what WCI says and get an own occupation policy with future increase option as a resident, from one of the top companies.

If you do look into NML, treat the agent as a salesperson (ie, take everything with a grain of salt until you see the contract, and assume they’re up selling you). Because they really are more like salesmen.

Can’t comment on AMA policy.

NWM If you look at it from 10,000 foot view. Sure if you're disabled you'll get paid no question. The issue I see with the policy is that if you transition to another occupation or specialty. Yes, it may lower your benefit. I guess my question would then be are you ok every month sending paystubs to the carrier getting questioned all the way?

No way, would I suggest changing if your health has declined from when you originally applied.

 

[acevmd1616]

Thanks for the message. It is just weird because my BP is ~134-140 systolic without meds, sleep apnea was so borderline that the sleep docs were like we can try CPAP just to see (and it didn't help) so I do not use it. I wonder if I order-sold my medical history to the independent agent (I think I wrote fatigue down too in the PMH box-which was really more sleepiness, which was why I wanted to pursue a home sleep study for my own curiosity).

Would it be worth it to try at a different independent broker? One that instead of just using the big 6, will look into others like Lloyd's? I wonder if other agents do soft inquiries with the big 6 again if that will trigger a red-flag.

The soft inquires are anonymous. No red flag.

Personally do not think you're wasting you time finding another broker.

 

[Please_Stand_By]

The soft inquires are anonymous. No red flag.

Personally do not think you're wasting you time finding another broker.

Thanks so much! If I hear any good news will update

 

[RangerBob]

NWM If you look at it from 10,000 foot view. Sure if you're disabled you'll get paid no question. The issue I see with the policy is that if you transition to another occupation or specialty. Yes, it may lower your benefit. I guess my question would then be are you ok every month sending paystubs to the carrier getting questioned all the way?

No way, would I suggest changing if your health has declined from when you originally applied.

Yes, this is the conundrum I am in. I think it's better than nothing, but it's definetely not as good as the big 6 policies. And now that I'm near 40, the odds of getting approved from one of the big 6 (when one denied me--so I have to disclose that on any future applications) is low.

It's ridiculous the things that will get excluded. Berkshire/Guardian wanted to exclude my entire R arm because I had a minor wrist sprain that required NSAID's for about a week or two. The only reason I even went to the doctor for it was it was work-related (patient with dementia who shook hands way too hard...) I took offense to it, and the things the others requested to exclude. NML said "we won't exclude that stuff," and I fell for it. I should've swallowed my pride and accepted the better policies with exclusions. It feels personal when they want to exclude things, but it's just the business of insurance--you pay based on what your risk is/potential benefits are.

 

[acevmd1616]

Yes, this is the conundrum I am in. I think it's better than nothing, but it's definetely not as good as the big 6 policies. And now that I'm near 40, the odds of getting approved from one of the big 6 (when one denied me--so I have to disclose that on any future applications) is low.

It's ridiculous the things that will get excluded. Berkshire/Guardian wanted to exclude my entire R arm because I had a minor wrist sprain that required NSAID's for about a week or two. The only reason I even went to the doctor for it was it was work-related (patient with dementia who shook hands way too hard...) I took offense to it, and the things the others requested to exclude. NML said "we won't exclude that stuff," and I fell for it. I should've swallowed my pride and accepted the better policies with exclusions. It feels personal when they want to exclude things, but it's just the business of insurance--you pay based on what your risk is/potential benefits are.

Can't beat yourself over that one. The odds are in your favor that you may never need to use it.

 

[MD Financial Services Scott]

Yes, this is the conundrum I am in. I think it's better than nothing, but it's definetely not as good as the big 6 policies. And now that I'm near 40, the odds of getting approved from one of the big 6 (when one denied me--so I have to disclose that on any future applications) is low.

It's ridiculous the things that will get excluded. Berkshire/Guardian wanted to exclude my entire R arm because I had a minor wrist sprain that required NSAID's for about a week or two. The only reason I even went to the doctor for it was it was work-related (patient with dementia who shook hands way too hard...) I took offense to it, and the things the others requested to exclude. NML said "we won't exclude that stuff," and I fell for it. I should've swallowed my pride and accepted the better policies with exclusions. It feels personal when they want to exclude things, but it's just the business of insurance--you pay based on what your risk is/potential benefits are.

Keep in mind that most carriers will put an exclusion on something like that to make sure that an insured is not trying to hang them with a claim right out of the gate but at a year or so most will remove those exclusions, you just have to ask.

 

[Please_Stand_By]

FYI for anyone wondering. I went through a different independent broker who had a very thorough questionnaire, and I was even able to input my sleep study results, BP values, etc.

They got back with quotes from 4 of the 6 this time! Hoping this works throughout the whole underwriting process and no eventual denials, but this is better than nothing!

 

[Splenda88]

If you are an attending, they are telling you that you need to pile up your money so you can be self insured in 5-7 years.

 

[Please_Stand_By]

A future job option I found out has an individual portable "guaranteed issue" LTD, but it's through a service called HFCB (Hinrichs Financial Corporate Benefits), which I take it is not going to utilize any of the big 6?

 

[MD Financial Services Scott]

They could broker none, one or all of the big 6 so ask but also make sure you get all of the discounts applied that you are eligible for. Sometimes deals outside of the companies ‘preferred provider group’ can actually be better. We see this all of the time when a unisex offering is present because the male rates are inflated to bring the female rates down.

 

[Please_Stand_By]

They could broker none, one or all of the big 6 so ask but also make sure you get all of the discounts applied that you are eligible for. Sometimes deals outside of the companies ‘preferred provider group’ can actually be better. We see this all of the time when a unisex offering is present because the male rates are inflated to bring the female rates down.

Thanks for the message, I will reach out to them. Interestingly I have read that if I used an independent broker and they formally applied, if I am in-fact rejected (even though I was given rates on 4/6 carries before the underwriting process), then I would not be able to get guaranteed issue since even guaranteed issue apparently asks if I had been rejected at any point prior.

Part of me thinks the conservative play would be to try to get guaranteed issue (if it's through any of the 6 that is) first than to risk trying right now as a fellow and going through the independent broker now.

 

[MD Financial Services Scott]

If there is a health issue present then absolutely apply for the GSI, lock that down and if you then want to shop around do it then.

 

[Please_Stand_By]

Is Lloyd's of London any good?

Found that this is offered as GSI through my work, but I won't find out the details (if own occupation) until I start. I may see their terms first, secure a policy there, then eventually apply for one of the big 6 with an independent broker (maybe through your service Scott) so that way if I am formally denied, at least there is still the GSI even if it may not be a true own-occ, I imagine the GSI is probably better than say NWM or equivalent, but I suppose all depends on terms.

 

[MD Financial Services Scott]

They are a non-traditional carrier with high issue limits but typically limited benefit period (5 years is typical). Check out the details of the policy, especially the elimination period language, definition of disability, benefit periods and any offsets they may have. If you decide to move forward with that then once you have it in hand then you can look around at other options.

 

[FlowRate]

For future reference, I am on a plan through Ohio National which is offered to graduating residents and requires NO medical underwriting. It's slightly more expensive than a fully underwritten plan but I have a condition that would definitely be disqualifying so it was my only option. If you're still in need of something similar, I can give you the contact info for the insurance broker I worked with. Our GME resident council had gotten a deal where there was a discount for it being offered/advertised to our entire system-wide GME. I locked in the rate for my age at the time which IIRC was $150 for $60k/yr coverage. I have guaranteed issue (no subsequent underwriting requirement) if I end up wanting more coverage in the future.

Between my own emergency fund, employer-sponsored DI, and retirement accounts, I don't personally see a need for more coverage currently.

 

[MD Financial Services Scott]

As an insurance agent we can typically get a GSI set up at any teaching hospital. We just have to have enough head count (% of the entire residency class) to average out the block of business otherwise these offerings can end up with all health risk individuals which then result in loss ratios greater than the carrier can accept. If the loss ratios get too high or the % of residents signing up is to low, then the carriers just shut down the plan.

 

[FlowRate]

If the loss ratios get too high or the % of residents signing up is to low, then the carriers just shut down the plan.

Curious, are you saying that 5 years from now Ohio could just say "well we don't like this plan anymore, too many people are using it, goodbye"? Or is it typically something that happens while the GSI is getting set up?

 

[MD Financial Services Scott]

No, not at all. What I am saying is if they don't get enough policy holders per year out of the total population in the program or the claims experience they will cancel the program offering for future policy holders. They can't come back and cancel your existing policy.