Disability insurrance

[MD Financial Services Scott]

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Thanks. I defer to you as these contracts are very complicated. I didn't see anything like that in my policy either but these companies are always trying to screw you over.

I know, it does happen but as I often say don't expect the carriers to over perform above the obligations in the policy details so always make sure your expectations of a claim have the obligations for the carrier in there that you need.

 

[Shimmy8]

Be careful, the rise of premiums can quickly overtake level premium contracts, ask them to show you what their level premium contract would be. In addition, you mention Occupation Specific definitions but really drill into that. What they say is if you can't do your specialty then full benefits are paid. Be sure to ask the next question of if you go work in another occupation and earn equal amount of money as you were earning what is your payment (answers is $0). That definition is a glorified Own Occupation and Not Working definition that they have dressed up and got trademarked to make it look fancy. The easy way to figure this out is to ask their claim department, what happens if I choose to work in Any Occupation post disability. Answer is % of income lost is % of benefit to be paid, if no loss then no payment. Depending on age most of the time residents/fellows and those just finishing are about $100- 120 per month per $5k of benefit on a Level Premium, best definition contract. Certainly age, gender, state of residency and health can adjust that but my point is that at $366 for $15k from NWM is not out of line but with them that is for the 3rd best definition and an increasing premium, when you take that into account I would suggest looking around.

I mean, who thinks they deserve their full payout then making extra $$$ on the side doing another occupation anyway? Isn't the point overall just to be made whole?

 

[DocVapor]

I mean, who thinks they deserve their full payout then making extra $$$ on the side doing another occupation anyway? Isn't the point overall just to be made whole?

I personally want to make the best of my life if I somehow become disabled. The insurance company offered that deal and I elect to pay for it. What I "deserve" is inconsequential.

 

[MD Financial Services Scott]

I mean, who thinks they deserve their full payout then making extra $$$ on the side doing another occupation anyway? Isn't the point overall just to be made whole?

Well I think one needs to look at it from a few different vantage points.
1: Your friends from College that immediately took that job in the market place has a 10+/- year jump on you for earnings because of med school, residency/fellowship that they did not experience nor the extra $200-$400k of school debt. If you become disabled and can't do that specific specialty you spent years training, accumulating debt, and differing your earnings capacity then some want that full benefit regardless of future income from another occupation or specialty they re-trained in. An example, Ortho Surgeon cuts off dominant hands thumb, has a $15k disability policy, income goes from $500k down to $250k thus a loss of $250k because they can't perform surgery. In that example, if they have a true own specialty plan for $15k they would get the $15k, if they have an Own Occupation Not Engaged with a residual rider they would get $7,500.

2: I would suggest that one should think about their specialty and IF they become disabled from their specialty would they have the ability to go do another occupation and while not being able to do their occupation. My comments are really focused on primary care type specialties, I think those deserve discussion around is their value in paying for that True Own Specialty definition or should they take the 10-20% premium discount to get the Own Occupation Not Engaged.

Totally their choice if they had wanted to buy a policy to protect that specialty but it certainly is not appropriate to say every doctor really should have a true own specialty plan, at least in my opinion. My point is don't accept a plan that on the surface sounds like a True Own Specialty definition when it is not and then still be charged the premium for it. Everyone is different and I suggest that ones expectations at claim time be fully thought out and then at policy acquisition make sure the terms required to execute on those expectations are included.

 

[BLADEMDA]

If any of you out there need disability or life insurance why not PM Scott Nelson-Archer for a quote? I am posting that recommendation because he is a straight shooter and he can provide you great advice as well.

I appreciate him posting here on our board and I can tell you he offers better policies/advice than the vast majority of local agents near you. For example, if I had purchased my policies from him (at the time) they would have cost me less and provided better coverage.

In this day and age there is NO EXCUSE not to use all the resources available to purchase the best product at the best price.

 

[BLADEMDA]

Claim Example

Consider this example* of what may happen at claim time:

Doug is a surgeon with a Platinum Advantage GSI policy that includes the Own Occupation (True Specialty Own Occ) definition. A disability makes him unable to perform surgical duties, the substantial and material duties of his surgeon occupation. Doug accepts a new position that he is able to perform despite his disability — an adjunct professor at a medical school. Because Doug’s policy included the Own Occupation definition, he can receive the full monthly benefit while earning income in his new occupation.

If Doug's policy had included the Regular Occupation (Modified Own Occ) definition, Doug wouldn't have qualified for a total disability benefit while earning income in his new occupation. Because he engaged in another job or occupation for wage or profit, he would have no longer met the criteria for being totally disabled.

* Example based on Platinum Advantage GSI coverage and benefits. This is for illustration purposes only and may not reflect actual claim experiences.

Read the Fine Print

When choosing an Own Occupation definition, choose the best fit for your cases. Consider the occupations of professionals covered and the income protection needs of the client. This will help you determine if Modified Own Occ or True Specialty Own Occ is the most appropriate recommendation.

When comparing carriers, read the contract language carefully to ensure you’re offering the Own Occ definition your client wants. Some carriers offer own occupation coverage that, on closer look, you’ll see is actually Modified Own Occ.

 

[IMGASMD]

I practiced internal medicine before anesthesia. I have MetLife as my carrier. I specifically asked if I injured my hands and no longer be able to perform my daily duties as an anesthesiologist, then what? That’s where I learned they determine your income/duties by researching your billing codes. So if my last year or two’s income were from anesthesia only then as long as my future income is not from those cpt codes, then I should be fine. (Edit: meaning if I go be a hospitalist or opening up a clinic, I can still keep those income. I foresee some scrutiny tho)

That’s why true occupancy is very important, we are all physicians, we can do a lot of things that can still generate income. Like the example above, a surgeon can no longer cut, can still practice as a physician, just the income potential is very very different. He paid to insure his future income of 150000/mo, not just to be made whole.

Edit: there’s also a psy and ID (blood borne illness) which are important for anesthesiologists that should be explored for new grads. Just remember it’s an “insurance” not an investment. No one is expected to use it, but sure will be glad when need it.

 

[chocomorsel]

$200 a month for a 45-50 y/o in Texas, for $15k a month benefit, through TMAIT. FWIW.......

Specialty specific, own occupation?

 

[MD Financial Services Scott]

Specialty specific, own occupation?

TMAIT does not offer what you would think of as own occ or true own specialty. What they offer is unable to do your own specialty but not working in any other occupation.

Other things to watch out for on TMAIT:
1: Read what constitutes a day during the waiting period, not just the number....
2: Rate adjustments (increases) at 40, 45, 50, 55, 60.
3: The ability for them to change the terms of the policy anytime they want.
4: The ability for them to cancel the policy anytime they want.
5: Another BIG issue that nobody ever notices is that IF you have an employer provided disability plan you absolutely need to read the 'income offset' provisions. In most employer plans there is an offset for "other group, association, or franchised plan benefits". What that means to you is that if you have that provision in your group plan, let's assume $10k per month, then you buy the TMAIT plan, $10k as well, then your group plan has $0 benefit responsibility because you bought something that allows them to offset your benefits dollar for dollar.

It is tricky out there, there are reasons these association and employer plans are less expensive and it is not because their population somehow has a lower morbidity rate than the other insurance companies.

I implore you to really read the policy, not just the brochure, words matter in these things and you need to know what they say so there is not a surprise if you happen to have a claim one day.