1. How is disability defined? Is it defined as the inability to perform your own job, or inability to do any job?
We recommend all our clients, as physicians, to obtain a policy that protects them in their own specialty. This kind of policy is defined as an own-occupation policy, which protects the income you earn in your own specialty and continues to pay benefits even if your disability allows you to work in a new specialty or occupation.
2. Are benefits available if I can work part-time in my specialty/occupation?
The most comprehensive policies will pay you a benefit even if you are not completely disabled. If you can only earn up to 15-20% of your income you are deemed totally disabled; if you can earn 75-80% or more you are deemed totally well. Partial or residual policies pay benefits when you fall in the category between 15-85%.
3. Are full benefits paid, whether or not you are able to work, for loss of sight, loss of hearing, or loss of limbs?
This is called a presumptive disability. Some policies do not cover presumptive disability, some pay until the end of the benefit period, and some pay you for life.
4. What is the maximum benefit I am eligible for?
The amount is based on your state of residence, income and specialty/occupation to a maximum of $20,000 per month with one company, and $30,000 per month with all companies.
5. Is the policy non-cancelable, guaranteed renewable, or conditionally renewable?
The most comprehensive policies are non-cancelable and guaranteed renewable; these put you in total control, not the insurance company, practice or association. The insurance company cannot raise rates, cannot reduce benefits, add exclusions, or cancel your policy. You are in total control, and the policy is portable and goes wherever you go.
6. How long must you be disabled before premiums are waived?
Premiums are waived at the end of the waiting period and refunded for the amount paid during the waiting period.
7. Is there an option to buy additional coverage, without undergoing additional medical tests or examinations, at a later date?
Yes, this option is available as a rider under a number of names. It is a guaranteed insurability rider and typically needs to be added to the base policy as a rider. It is critical for a physician just beginning practice to have this option available in order to keep coverage in line with income. The only requirement necessary to exercise this option is income documentation.
8. Does the policy offer an inflation adjustment feature? If so, what is the rate of inflation? Is there a maximum?
This feature is available as an added rider (COLA). It is typically more cost-effective to use the extra premium for this rider to instead purchase a larger monthly benefit.
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