How much money have you spent/received on disability/life insurance?

[MD Financial Services Scott]

I hope @MD Financial Services Scott can provide his company's statistics on permanent disability rates for his physician clients.

The question is actually to broad to accurately answer because we could be talking different specialties, different types of policies and how they consider an insured disabled, if you are meaning permanent that too means something different to carriers and individuals. As an example if you were an anesthesiologist and lost your thumb and index finger on your dominant hand then that would most likely be a permanent disability (depending on the language of your policy) but if you were a psychiatrist it would most likely be a temporary claim. There are just a million scenarios to deal with so pretty hard to say X is the number.

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[Mikkel]

The question is actually to broad to accurately answer because we could be talking different specialties, different types of policies and how they consider an insured disabled, if you are meaning permanent that too means something different to carriers and individuals. As an example if you were an anesthesiologist and lost your thumb and index finger on your dominant hand then that would most likely be a permanent disability (depending on the language of your policy) but if you were a psychiatrist it would most likely be a temporary claim. There are just a million scenarios to deal with so pretty hard to say X is the number.

As of now in 2019, about how many physicians are receiving permanent disability benefits and how many physicians are you insuring?

1/10?
1/100?
1/1,000?
1/10,000?

 

[MD Financial Services Scott]

I hope you don't treat it as playing the lottery which is a game one hopes to win. Disability is not a game you hope to win at....

Most of the top insurance companies that have a disability product in the market place have simply in their policy 'if you have the inability to perform the material and substantial duties of the medical specialty that you were doing at the time of claim the benefits are payable'. The best carriers in the market place determine your specialty based on the CPT codes that were being billed for, the worst (typically group policies) will use the department of labor guidelines. Surprisingly most of the time when it a person is claiming to still be disabled, it is their attending physician who is telling the insurance company this person is able to go back to work. Keep in mind the attending physician is the one they picked not some corporate physician on staff with the insurance company.

 

[MD Financial Services Scott]

As of now in 2019, about how many physicians are receiving permanent disability benefits and how many physicians are you insuring?

1/10?
1/100?
1/1,000?
1/10,000?

I think what is throwing off the conversation is the word permanent vs. total. Permanent in the disability world is about something that can never right itself again vs. total means that the client is eligible for full benefits. Now permanent claim could be a partial claim and a total claim might not be permanent.
In 2019 we probably have been processing 1-3 new claims per week, don't know total clients but it is certainly in the thousands as I have been in this business since 1993....

 

[NITRAS]

I'm trying to decide whether to buy more coverage than I already have. I have $5k/month now.

Do you want to live on $5000/month if you get disabled?

No? Then buy more.
It’s that simple. Insurance companies have to make a profit, or they go broke. Actually a majority of the funds are not paid out in claims. Simply put, I’m happier paying the insurance companies profit than to risk my dying/being disabled without enough savings to care for my family.

 

[Mikkel]

I think what is throwing off the conversation is the word permanent vs. total. Permanent in the disability world is about something that can never right itself again vs. total means that the client is eligible for full benefits. Now permanent claim could be a partial claim and a total claim might not be permanent.
In 2019 we probably have been processing 1-3 new claims per week, don't know total clients but it is certainly in the thousands as I have been in this business since 1993....

Ok, simplify the criteria.


How many of your insured physician clients are receiving any benefits for over 5 years?

How many insured physician clients are in your pool?

Claim numbers are irrelevant.

 

[sethco]

I don’t know your situation but that’s low. I have more than double that at this point in my career and I can self insure. I recommend you consider your needs/expenses and I’m thinking $10k per month should still be quite reasonable to purchase for you. The cost for $10k per month should be around $2500 per year (maybe less) depending on the policy.

Once you hit your F U money plus savings/investments then you can always cancel the policy (stop paying on it)

If you can self insure, what is the point of having disability and life insurance? Asking another way, when you can self insure, why don't you consider yourself financially independent?

 

[Mikkel]

Do you want to live on $5000/month if you get disabled?

No? Then buy more.
It’s that simple. Insurance companies have to make a profit, or they go broke. Actually a majority of the funds are not paid out in claims. Simply put, I’m happier paying the insurance companies profit than to risk my dying/being disabled without enough savings to care for my family.

That's a silly reason to spend money on something you don't actually need, which is why we need the stats on physician permanent disability.

If I have a 10% chance of being permanently and totally disabled, I will buy $40k/year coverage in a heartbeat, I don't care what the premium is.

My anecdotal experience from a couple of decades in medicine is it's extremely rare for total and permanent incapacitation (ie at normal population rates, or less than general population rate, because of better risk aversion and more educated understanding of the world).

 

[Arch Guillotti]

I also have never personally heard of any anesthesiologists who have gotten so disabled that they went on permanent disability.

I have.

 

[ProtonPump]

If I have a 10% chance of being permanently and totally disabled, I will buy $40k/year coverage in a heartbeat, I don't care what the premium is.

You could collect the data for what are the chances your house gets burned in a fire (or flooded, or whatever natural disasters happen in your area) even if the quoted probability were 1:100000 or less a lot of people would get insurance if they couldn’t afford to replace what they lost and the risk was meaningful to them. Afterall as an individual your house either burns down or it doesn’t; you either have a reason to claim on your insurance or you don’t. The one thing a probablity doesn’t tell you is who the event(the risk you’re covering against) is going to happen to. You can collect all the pre-test probabilities that you want; to me it seems the challenge is that population level statistics work great when the sample size is large but at the individual level that coin can come up heads ten times in a row and when we look at the post test probability of binary events then either it was 0 or 1.0.

 

[ChiDO]

$700/year for $2mil 20 year term life insurance.

$2600ish for $18k/month own occ disability.

 

[BLADEMDA]

$700/year for $2mil 20 year term life insurance.

$2600ish for $18k/month own occ disability.

Fantastic rates on those policies assuming A rated Insurance company/companies. Maybe, add a 30 year policy for $500K?
Even though I can self insure completely I like having the life insurance and disability in place until my early 60's. I was able to cut back significantly on the cost of those policies but $2600 per year for $18K per month is outstanding.

 

[BLADEMDA]

That's a silly reason to spend money on something you don't actually need, which is why we need the stats on physician permanent disability.

If I have a 10% chance of being permanently and totally disabled, I will buy $40k/year coverage in a heartbeat, I don't care what the premium is.

My anecdotal experience from a couple of decades in medicine is it's extremely rare for total and permanent incapacitation (ie at normal population rates, or less than general population rate, because of better risk aversion and more educated understanding of the world).

Buy own occupation specific disability insurance or don't bother buying any at all. Second, I hope NEVER to use any of my term or disability insurance. I consider never needing to use them a win. But, if I get disabled why not have that $10K per month policy in place just in case? If you can't afford it then don't buy it. As for not needing it well the odds favor you on that one but suck it up and get some anyway.

Is Disability Insurance Worth It? Here’s When It’s Not | White Coat Investor

Are there some doctors who don't need disability insurance? There sure are, but you're probably not one of them. Click here to find out if you're an exception.

www.whitecoatinvestor.com

I'll be dropping my insurance entirely by age 61. Perhaps, even sooner now that we are discussing the subject.

 

[BLADEMDA]

"if you are working because you need income, you need disability insurance. It is that simple. "

Now, go buy some disability insurance and compare costs/benefits/etc before purchasing

 

[cks33]

the AMA has a great plan for a dirt cheap rate...im paying 500 a year for 5K monthly benefits (my job also provides short term of 5K per month)

 

[dchz]

That's what I feel like, slick salespeople who take advantage of emotions to sell a product you'll be highly unlikely to use, and peer pressure to convince you to buy as much insurance as possible.

If someone told me to spend $200 every month on lottery tickets, part of me thinks it's a good idea, because there's a small chance that 36,000 lottery tickets purchased over 30 years could pay out millions, but my reasonable self tells me chances are good that I would never win anything.

we disagreed a lot on the car front, but i am completely with you that this insurance is overpriced.

The point of all insurances is that the Expected Value of the insurance policy is less than you paid for it.

I don't expect insurance companies to work for free, but it just feels like the expected value of most disability insurance is WAY less than the premium you paid for.

 

[dchz]

Dude, I don’t understand the point of your post. If you don’t want it, don’t buy it.

Well. He does have a good point.

If we know what percentage of physicians go on disability. The cost would be the payment in perpetuity paid out in present day value multiplied by that probability.

a). Cost said annuity x % chance of that even occurring in the next # of years (this is the actuary info that @Mikkel is asking about, it would shine a lot of light on the issue).

What do they charge?

b). Premium of insurance x # of years. (in present day value if you want to account for time value of money)

What would be an acceptable ratio of a to b? 1:10? 1:100? 1:1000?
What if I told you that ratio for a lottery ticket is like 1:2? does that give you some perspective?

No one is denying there is value in having a safety net. But i think a lot of us are neglecting to see how much that safety net costs.


The devil is in the details.

 

[dchz]

One last perspective:

a $5000 per month annuity would cost $1.5 million dollars.

If you have a 1% chance of cashing in on the disability the value to you of that annuity is $15,000. that $15k total, not per month.

If the chance is 0.1%, meaning you only want 0.1% of that payout. that payout is worth $1.5k.

The only other thing not accounted for is the volatility of losing a job and etc. no one can tell you how much that means to you. You have to decide for yourself.

But I feel like we, as physicians, don't understand the following:

If you pay $6k per year for a $5k per month payout, and you have a 0.1% chance of becoming permanently disabled in that 1 year. You've paid $4.5K ($6k in annual premiums - value of that payout, which one can buy for $1.5k) just to have that peace of mind, you've paid $4.5k to not have that volatility.

For some, $4.5k per year to protect against a 0.1% chance catastrophic loss is def worth it. For others it's not. I'm not here to judge that. But the problem that I have is that people don't understand they are paying $4.5k to have peace of mind.

 

[Splenda88]

One last perspective:

For some, $4.5k per year to protect against a 0.1% chance catastrophic loss is def worth it. For others it's not. I'm not here to judge that. But the problem that I have is that people don't understand they are paying $4.5k to have peace of mind.

That is exactly what these companies sell you. I purchased 250k 30yr term for $500/yr... That was ~9 yrs ago and what you said is exactly what the broker who is a good friend of mine told me. "It's money wasted, but you have your peace of mind."

 

[VA Hopeful Dr]

That is exactly what these companies sell you. I purchased 250k 30yr term for $500/yr... That was ~9 yrs ago and what you said is exactly what the broker who is a good friend of mine told me. "It's money wasted, but you have your peace of mind."

It's money wasted... Until it's not.

Also, unless you are much older than I am or have health issues you massively overpaid for that policy.

 

[Splenda88]

It's money wasted... Until it's not.

Also, unless you are much older than I am or have health issues you massively overpaid for that policy.

Playing lottery is also money wasted until it's not. It's all stats. We all are guilty of buying that peace of mind. I will not discourage anyone from buying life/DI. But spending 7k/year on them as a physician is a little bit excessive IMO.

I am probably a bit older than you but I have no health issues...

 

[VA Hopeful Dr]

Playing lottery is also money wasted until it's not. It's all stats. We all are guilty of buying that peace of mind. I will not discourage anyone from buying life/DI. But spending 7k/year on them as a physician is a little bit excessive IMO.

I am probably a bit older than you but I have no health issues...

I phrased that poorly, unless 8 years older than I am you are overpaying by a lot. I picked up my 1 million 30 year policy at age 34 for $280/year and that's with being on cholesterol medication and being technically overweight (BMI was 26 at the time).

If you think that disability/life insurance is literally playing the lottery, not sure there's anything more to discuss.

 

[Mikkel]

I phrased that poorly, unless 8 years older than I am you are overpaying by a lot. I picked up my 1 million 30 year policy at age 34 for $280/year and that's with being on cholesterol medication and being technically overweight (BMI was 26 at the time).

If you think that disability/life insurance is literally playing the lottery, not sure there's anything more to discuss.

Permanent DI/LI are advertised almost exactly the same as the lottery: "it could be you!"

The probabilities of winning are similar as well.

I've played the lottery before. With a few inexpensive tickets, I had peace of mind that I had a chance to be able to quit my job and spend all my time with family and forever provide for my children/grandchildren.

 

[Mman]

we disagreed a lot on the car front, but i am completely with you that this insurance is overpriced.

The point of all insurances is that the Expected Value of the insurance policy is less than you paid for it.

I don't expect insurance companies to work for free, but it just feels like the expected value of most disability insurance is WAY less than the premium you paid for.

While it may seem that way, it is quite unlikely to be that way. Why? Competition in the market. If one company had such a massive profit margin on the product, others would undercut them. Rinse and repeat until the profit margin for that product is basically the same as any other insurance product.

Unless you think there is some massive collusion in that industry that does not impact other insurance products.

 

[VA Hopeful Dr]

Permanent DI/LI are advertised almost exactly the same as the lottery: "it could be you!"

The probabilities of winning are similar as well.

I've played the lottery before. With a few inexpensive tickets, I had peace of mind that I had a chance to be able to quit my job and spend all my time with family and forever provide for my children/grandchildren.

Well in that case every form of insurance is exactly the same as the lottery.

You've converted me!

 

[NITRAS]

Permanent DI/LI are advertised almost exactly the same as the lottery: "it could be you!"

The probabilities of winning are similar as well.

I've played the lottery before. With a few inexpensive tickets, I had peace of mind that I had a chance to be able to quit my job and spend all my time with family and forever provide for my children/grandchildren.

Neither the lottery nor insurance are good investments. No one is arguing that. Lots of insurance products out there are ****ty. But I’m young and have a family. It’s risk management.

 

[Splenda88]

I phrased that poorly, unless 8 years older than I am you are overpaying by a lot. I picked up my 1 million 30 year policy at age 34 for $280/year and that's with being on cholesterol medication and being technically overweight (BMI was 26 at the time).

If you think that disability/life insurance is literally playing the lottery, not sure there's anything more to discuss.

Since yours is that cheap I guess my spouse and I overpaid by a lot... I am not on any meds but my BMI is 25Ish...

 

[Mikkel]

While it may seem that way, it is quite unlikely to be that way. Why? Competition in the market. If one company had such a massive profit margin on the product, others would undercut them. Rinse and repeat until the profit margin for that product is basically the same as any other insurance product.

Unless you think there is some massive collusion in that industry that does not impact other insurance products.

Price inelasticity in physician disability insurance gives power to the insurance companies to maximize revenue and profit from their policies.

With none of the insurers offering any stats for claims and permanent disability, it is impossible to assess whether the market in general is overpriced, which is why they want to keep you in the dark.

Yes, while individual insurers behave somewhat as a market (though limited because of lack of advertised price), the market equilibrium as a whole is overvalued.

 

[Mikkel]

Neither the lottery nor insurance are good investments. No one is arguing that. Lots of insurance products out there are ****ty. But I’m young and have a family. It’s risk management.

I agree, it's risk management, but determining actual risk and therefore appropriate pricing of the product is impossible.

 

[caveat87]

For reference i am fairly early in my career. paying roughly $2500 annually for a policy which would pay out 5.5k per month after tax with inflation adjustment until age 68 if i was to become permanently disabled. I believe my work pays for a not as great policy that would pay 4k after tax per month. i figure therefore having a guaranteed 100k income for the rest of my life in case something catastrophic happens is worth it for at least the first 10 years or so of my career until i can self insure with a passive income stream.

Agree that life insurance is cheap and totally worth it...got a decent plan that would provide 2 million to my wife/family in case of early demise

Most people I've chatted with seem to think own occupation DI is a must until you can self insure. I know that policy agents make big $$$ off the commissions but i'd rather not be SOL if i find myself unable to work, especially this early on

 

[BLADEMDA]

Price inelasticity in physician disability insurance gives power to the insurance companies to maximize revenue and profit from their policies.

With none of the insurers offering any stats for claims and permanent disability, it is impossible to assess whether the market in general is overpriced, which is why they want to keep you in the dark.

Yes, while individual insurers behave somewhat as a market (though limited because of lack of advertised price), the market equilibrium as a whole is overvalued.

Why not get some quotes? Members on SDN have received some great rates on insurance. Maybe, you can get a good disability policy for $175 per month? Until you come back and post some actual costs for the policy I wouldn't worry about claims.

An SDN member got a $1 million term 30 life insurance for $280. $280 per year. Dirt cheap IMHO.

 

[Mikkel]

Well in that case every form of insurance is exactly the same as the lottery.

You've converted me!

At least with auto and home insurance, there are known risks and available data that help you determine how much to spend.

Flood insurance in most of Phoenix would be a waste of money, but you could make an argument for "what if..." and pay for it anyway.

 

[BLADEMDA]

"Norm" had no life insurance. He was earning great money but never thought he needed life insurance. He was sadly mistaken.

Dearest UT Southwestern, a.k.a. NORM

Dear UT, I'll preface this post with the fact that I love to write, and hope to publish a novel someday. My writing coach and mentor, an accomplished screenwriter, doctor712, has told me incessantly to write unfiltered. With that said, I'll take his advice during this post...and write...

forums.studentdoctor.net

 

[VA Hopeful Dr]

Price inelasticity in physician disability insurance gives power to the insurance companies to maximize revenue and profit from their policies.

With none of the insurers offering any stats for claims and permanent disability, it is impossible to assess whether the market in general is overpriced, which is why they want to keep you in the dark.

Yes, while individual insurers behave somewhat as a market (though limited because of lack of advertised price), the market equilibrium as a whole is overvalued.

If the market was overpriced, you wouldn't see major insurance companies getting out of the individual disability game. My policy is with MetLife. 2 years ago they stopped issuing individual policies. When we signed up my wife's policy, the agent said in the 5 years previous 3 of the companies he used to use a lot had stopped issuing individual policies as well. If it were all that profitable, wouldn't MORE companies be doing disability instead of less?

 

[VA Hopeful Dr]

At least with auto and home insurance, there are known risks and available data that help you determine how much to spend.

Flood insurance in most of Phoenix would be a waste of money, but you could make an argument for "what if..." and pay for it anyway.

https://ktar.com/story/2241707/social-media-captures-images-of-flooding-in-phoenix-area/

 

[BLADEMDA]

"Don't go through life blindly focused on just making money. Doing so robbed me of perspective and enjoyment of life until cancer finally gave me the proper frame of mind to understand that what we do with our lives can truly change the world and give so many people the hope and understanding they need to make their lives fulfilling and rewarding. Without that ability, your life can be a droning repetition of daily activity, from which you view an ending of it as a blessing. That is not the way to live. That is just a way to exist. "

UT Southwestern

 

[Mikkel]

An SDN member got a $1 million term 30 life insurance for $280. $280 per year. Dirt cheap IMHO.

Dirt cheap because the chance of a healthy young physician dying by age 60 is exceedingly uncommon.

Frankly, $280 worth of lottery tickets every year is dirt cheap too, considering the payout could be over $100,000,000.

 

[Mman]

Dirt cheap because the chance of a healthy young physician dying by age 60 is exceedingly uncommon.

Frankly, $280 worth of lottery tickets every year is dirt cheap too, considering the payout could be over $100,000,000.

I know of at least 5 or 10 physicians in our hospital (admittedly large) that died before age 60 in the last decade. They were all young and healthy when they were 30. Stuff happens. You can feel free to not purchase any life insurance. The decision could literally never hurt you in any way. It's your spouse and children that would be the ones that suffer.

I personally feel just a little bit better when I get on a plane or drive down the freeway knowing my wife kids will be financially set even if something catastrophic happens. Because while my current income is high, if I dropped dead I'd be leaving them with a mortgage and student loans etc and no further income to help pay that back.


In my life I have never met someone that was happy they were underinsured. I have met plenty of people that were grateful they were properly insured.

 

[BLADEMDA]

Dirt cheap because the chance of a healthy young physician dying by age 60 is exceedingly uncommon.

Frankly, $280 worth of lottery tickets every year is dirt cheap too, considering the payout could be over $100,000,000.

Norm's wife would have appreciated the life insurance policy over a lottery ticket. $280 is chump change for the safety net it brings to one's family.

 

[Mman]

With none of the insurers offering any stats for claims and permanent disability, it is impossible to assess whether the market in general is overpriced, which is why they want to keep you in the dark.

Plenty of insurers are publicly traded companies that release financial data on a quarterly and annual basis. I'm too lazy to dig it up, but it's probably out there if you want to find it.

 

[thinkorswim]

Dirt cheap because the chance of a healthy young physician dying by age 60 is exceedingly uncommon.

Frankly, $280 worth of lottery tickets every year is dirt cheap too, considering the payout could be over $100,000,000.

Do you have a family that depends on you? A spouse or kids? An elderly parent? I’m guessing no, because you wouldn’t view life insurance this way if you did.

The thought of me dying doesn’t scare me. The thought of my loved ones not being able to financially care for themselves after I’m gone is what does.

 

[Mikkel]

I know of at least 5 or 10 physicians in our hospital (admittedly large) that died before age 60 in the last decade. They were all young and healthy when they were 30. Stuff happens. You can feel free to not purchase any life insurance. The decision could literally never hurt you in any way. It's your spouse and children that would be the ones that suffer.

25+ years working as a physician, saving prudently, paying off mortgages early, saving for kid's college. But a $1mil policy is the deciding factor in whether your surviving family will suffer financially?

 

[BLADEMDA]

25+ years working as a physician, saving prudently, paying off mortgages early, saving for kid's college. But a $1mil policy is the deciding factor in whether your surviving family will suffer financially?

You are clearly misinformed about insurance and the ravages of time. You won't view the world the same way in 20 years and your ability to even get insurance down the road may be limited or extremely expensive.

I'll keep it simple:

1. Do you have a loved one that relies on your income? Would you like to leave a loved one money in case of your demise? If either answer is yes, then buy life insurance.

2. A teenager on his cellular phone plows into you. You suffer severe injuries and require a 3 level cervical fusion. You no longer have full use of your hands. Hence, you can't work as an Anesthesiologist at your current job. Do you have the financial means to support yourself without working as an Anesthesiologist? If the answer is "no" you need disability insurance. Now, how much money do you need per month in this scenario? Typically, the money is tax free so would $10K per month suffice?

I can assure you that time can be cruel and we are all humans susceptible to disease and injury. If you wait to purchase these policies the cost may go up significantly as they did for me. I added a $1 million term 20 policy (years ago) and it cost me 2X what my initial term 20 did after residency.

I highly recommend you purchase these policies by age 35 if at all possible.

 

[VA Hopeful Dr]

25+ years working as a physician, saving prudently, paying off mortgages early, saving for kid's college. But a $1mil policy is the deciding factor in whether your surviving family will suffer financially?

If you do all of that well then you can always cancel your policy when you hit the point that you wouldn't need the life insurance. That's one of the benefits, you can just stop paying for it at any time.

 

[dabears505]

It takes one second to become disabled to the point you might not be able to do anesthesia. Car accident with severe hand or head injury. Sports injury that might not allow complete return to normal function. Trust me from experience, you would be a fool to not pony up for disability

 

[MD Financial Services Scott]

the AMA has a great plan for a dirt cheap rate...im paying 500 a year for 5K monthly benefits (my job also provides short term of 5K per month)

Make sure you read the policy and not the sales brochure....
The AMA policy has a 'Total and Continuous' clause in the elimination period vs. loss of 15% of income (far from total or continuous)
It is not an Own Specialty definition as it implies, it is an own occ not engaged definition
They can change the language in your policy anytime they want
They can change the rate anytime they want
You have a 30%+/- rate hike every 5th year ending in 0 or 5.

 

[Mikkel]

It takes one second to become disabled to the point you might not be able to do anesthesia. Car accident with severe hand or head injury. Sports injury that might not allow complete return to normal function. Trust me from experience, you would be a fool to not pony up for disability

It takes one lottery ticket for you to retire, to own a yacht and a beachfront mansion, to have a butler and a private plane.

 

[Splenda88]

No one is telling anyone not to purchase life insurance. Insurance brokers would tell you to buy 7X coverage of your annual salary. An anesthesiologist who is making 400k should purchase coverage for ~ 3 mil. That's excessive IMO. The chance of your demise in the next 10 years after you become an attending is extremely low.

I have a 250k coverage life insurance(LI) coverage now but no DI insurance. Of course I will purchase an addition 500k LI and 750k DI when I become an attending because I would want my family to be financially Ok if something catastrophic happens. If something happens, I hope my spouse would downsize and not try to live as if I was bringing 250-300k/year.

 

[BLADEMDA]

It takes one lottery ticket for you to retire, to own a yacht and a beachfront mansion, to have a butler and a private plane.

Insurance is the lotto ticket you hope never wins. You have it just in case life doesn’t go your way. FYI, the odds of becoming disabled are far greater than the odds of winning the lotto.

 

[VA Hopeful Dr]

No one is telling anyone not to purchase life insurance. Insurance brokers would tell you to buy 7X coverage of your annual salary. An anesthesiologist who is making 400k should purchase coverage for ~ 3 mil. That's excessive IMO. The chance of your demise in the next 10 years after you become an attending is extremely low.

I have a 250k coverage life insurance(LI) coverage now but no DI insurance. Of course I will purchase an addition 500k LI and 750k DI when I become an attending because I would want my family to be financially Ok if something catastrophic happens. If something happens, I hope my spouse would downsize and not try to live as if I was bringing 250-300k/year.

Lots of people want their spouse to not have to change their lifestyle by a huge amount - obviously some decrease is expected but you don't want your spouse to have to sell the house, make the kids change schools, or anything like that.

I have less than most here because my wife is also a physician. My policy will pay off our mortgage, all loans, and set up our kids' college funds. Her income will then be more than enough to maintain the current COL. Her policy does the same.