Any Occupation
Defines 'disability' as the inability to perform the material and substantial duties of ANY occupation for which you are suited by training, education, or experience. This includes the ability to complete tasks outside of medicine and is one of the broadest definitions of disability.
Benefit
How much money the disability carrier would pay you per month if you were to become disabled.
Benefit Period
The benefit period is the length of time the disability carrier will provide protection. This is also the length of time that you could receive your monthly benefit while on a disability claim. We generally set policies with a benefit period to age 65, meaning you will have coverage and the ability to make a claim and collect monthly benefits if you were unable to work up until then.
Claim
If you experience a disability/injury that results in time away from work or loss of income, you will want to file a claim with the disability carrier. We cannot be a part of the actual claims process, but we can help you with where to start and answer questions you may have along the way. You should file your claim as soon as possible to start the elimination period.
After the elimination period has passed (between 30-365 days), you will receive your monthly benefit while on the disability claim.
Cost of Living Adjustment (COLA)
The COLA feature allows your monthly benefit to keep up with inflation while you are on a disability claim. There are varying levels of COLA (3%, 0-3%, 0-6%, 2-6%). At a minimum, we recommend adding a 3% COLA to every disability policy. This means that if you were to go on claim, your disability benefit would increase by 3% per year to keep up with inflation.
Definition of Disability
This is one of the most important aspects of a disability insurance policy for physicians. The definition is what determines whether you would be considered “disabled” due to an illness or injury, and therefore if you are eligible to receive the monthly disability benefit. There are several definitions of disability including True Own-Occupation, Own-Occupation, Modified Own-Occupation, Transitional Occupation, Regular Occupation, Total Disability, Catastrophic Disability, etc.
True Double Dip Own-Occupation is the strictest definition of disability and highest level of coverage for physicians as it protects your specialty and daily duties at the time of disability, regardless of your ability to work in another capacity.
Double-Dip
The Double-Dip element is what allows you to still earn an income while on a disability claim. For example, if you could no longer perform your regular daily duties, but you wanted (and were able) to re-train for another specialty or work in another occupation altogether, that income you earn will NOT offset the monthly disability benefit you are receiving.
Enhanced Medical Own-Occupation
If more than 50% of your income is earned from hands-on patient care or surgical procedures, you will be considered totally disabled even if you are gainfully employed in your practice or another occupation as long as you are not able to provide those hands-on patient care or surgical procedures solely due to injury or illness.
Hands-on Patient Care - Meeting with patients in a clinical setting to regularly provide medical advice, evaluation, diagnosis, or treatment during the 12 months prior to your disability.
Surgical Procedures - Medical interventions involving an incision with instruments regularly performed by you in a clinical or hospital setting normally involving anesthesia and/or respiratory assistance during the 12 months prior to your disability. These procedures can be performed on either an inpatient or outpatient basis.
Exclusion
Exclusions are specific circumstances or body parts for which a disability carrier would NOT pay out a disability benefit. These can often be due to pre-existing conditions or historical medical events.
For example, if a physician had previously broken their arm requiring surgery to place plates and screws, they may get approved for disability coverage with an exclusion for that arm. This means that the disability carrier will cover disabilities except those arising from said arm. In some cases, carriers will also allow a reconsideration period where if after a set amount of time no further issues arise from the excluded area, the physician can apply to get the exclusion removed from my policy.
Future Purchase Option
This rider may be referred to by a different name depending on disability carrier, but it refers to the ability to increase your monthly benefit in the future with no medical questions asked. This gives physicians the ability to secure coverage when they are young, lock in their health status, and then increase in the future regardless of changes to their health. It is common to increase disability coverage when transitioning from training to practice to protect the new, higher income
Guaranteed Renewable
Guaranteed renewable means the insurance carrier can never cancel the policy or change the terms of the contract as long as you continue to pay your coverage premiums.
Lock Current Rates For Future Purchase
If your policy has a discount attached to it when you secure coverage (like a training discount, for example), the carrier will apply that discount to any additional coverage you pick up in the future.
Long-Term Disability
A loss of income due to a disability that lasts longer than the elimination period is considered long-term disability. A typical elimination period is 90 days, meaning you would then start receiving your disability benefit on the 91st day of the claim.
Mental Nervous Benefit
This is a clause within a disability policy saying they will provide benefit based on a mental nervous and substance abuse claim, like depression, anxiety, bipolar, or substance abuse.
In general, carriers cover mental nervous claims for 24 months, after which hospitalization is required to continue to receive benefits. If this aspect of the policy is particularly important to you, it's important to let your insurance specialist know.
Non-Cancelable
Used with the guaranteed-renewable clause of a disability policy to prohibit the insurance company from raising your cost in the future.
Occupation Class
Occupation class is one of the main factors in the cost of disability coverage and is determined by your specialty when you initially apply. Each carrier has its own way of sorting occupation classes and specialties.
Because of these classifications, a physician can pick up coverage as an internal medicine resident (at a relatively low cost) and maintain that occupation class even if they went on to specialize in something like Cardio EP, which would be a different occupation class, set of daily duties, and higher cost if they waited to pick up coverage until then.
Partial (Residual) Disability
Three quarters of claims are considered partial disability claims. This means the person can still perform most of their daily duties but is limited in terms of workload. If an illness or injury results in a partial loss of income due to a disability, the physician will qualify for the same percentage of disability benefit - i.e., 50% loss of income = 50% of your disability benefit.
Premium
The amount of money that you have to pay for your insurance policy. Payments can be made monthly, quarterly, or annually.
Recovery Benefit
Recovery benefit is often tied to the residual benefit rider and continues to pay you a benefit once you return to work due to a continued loss of income until you are 100%. Many physicians who go on a disability claim are eventually able to return to work but in a limited capacity. Once you resume working, the recovery benefit allows you to receive a portion of your monthly disability benefit for the continued loss of income until you can return to 100% capacity.
Rider
A rider is an added feature to a disability policy that enhances protection. Examples of riders include Cost of Living Adjustment (COLA), Recovery Benefit, Residual Benefit, Future Purchase Option, etc..
True Double-Dip Own-Occupation
True Own-Occupation defines disability as "the inability to perform the material and substantial duties of your occupation at the time of disability, regardless if you choose to work in a broader specialty or different occupation". This is the most specific definition of disability and highest level of protection for physicians. The double-dip portion refers to the ability to earn an income while on a disability claim (see more above).
Waiting Period (Elimination Period)
The waiting or eleimination persiod is the amount of time with a loss of income due to a disability that must pass in order to start receiving your monthly benefit. Options may include a 60, 90, 180 or 360 day elimination period.