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Own-Occupation Definition of Disability

As a highly trained physician, it is in your best interest to seek a true “Own-Occupation” definition of disability policy.  Under this definition of disability, you will be deemed totally disabled if you are unable to perform the substantial and material duties of your occupation.  If you choose to work in another occupation, you will still receive full benefits, regardless of the income you earn from the other occupation.”

Residual/ Partial Disability Benefit

Under a disability insurance policy, if you are residually disabled, the insurer pays a monthly income benefit at the end of each month while you are residually disabled. Initially, the insurer may pay a loss of income indemnity, which is essentially a cash payment to you for your full income benefit. If you remain to be residually disabled in the same claim after the loss of income indemnity has been paid for a period of time, the insurer pays a residual cash indemnity, which is determined by a formula using your monthly loss of income divided by your prior income times your monthly indemnity percentage.

Recovery Benefit

A recovery benefit allows benefits to continue following recovery from disability.  It is intended to fill the income gap when you are no longer medically disabled but still experiences an income reduction of more than 15-20%, The loss must be directly and solely due to the injury or sickness that caused your prior disability

Future Purchase Option

Most advisors would agree that this is a must for most physicians establishing disability coverage

before age 40. This provision allows an increase of monthly benefits in the future, regardless of

health, as long as your income qualifies. After age 50, the rules can change depending on the insurance contract you have- it is important to read the fine print. 

Some of the options are available for you to purchase, in which you can choose to increase your policy usually once per year, up to the age limit.  The other type of options is no-cost rider often called a “benefit update” option and is usually offered every three years but with the stipulation that if you don’t provide income verification and take advantage on part or all of the eligible offer, the option can be removed from the contract.

Cost of Living Adjustment rider

This rider increases the monthly benefit after one year of receiving disability benefits, either by a fixed percentage or based on the Consumer Price Index, up to a predetermined cap – usually 3% to 6%. This rider is an expensive option, and financially may not be cost-effective, especially if you are establishing coverage after age 40.

Catastrophic rider

This rider provides an extra income benefit, so you'll have the flexibility to do things such as hire help and pay for items not covered by your health insurance. This can result in up to 100% income replacement when combined with the base policy benefit and other disability coverage.


Is my current plan sufficient?

There are a number of special factors that physicians and other medical professionals should take into account when considering disability income insurance. Traditional group disability insurance and association plans may be insufficient to protect the income of a highly-trained medical professional. If you were physically able to work in a different branch of medicine, or even to be gainfully employed in a totally different occupation, there is a possibility that benefits can be limited or denied. This might come as a shock to physicians who have spent years in residency, fellowship, and even passed multiple board exams to get to where they are today.


Why should I work with you?

Physicians need a well-designed disability income insurance plan that can provide adequate income protection as their careers progress, but selecting the right coverage and company can be a challenge. A financial adviser who specializes in working with medical professionals can provide valuable perspective and judgment in the selection process. The appropriate adviser should have a fiduciary responsibility to represent your best interests. Inquire about the adviser’s credentials, the volume of disability insurance they write, and how many companies they work with in order to get the policy that suits you best.

What are my chances of becoming disabled?

The odds of a 20-year-old becoming disabled before reaching age 67 is 1 in 4. This is according to the Social Security Administration Fact Sheet-September 2017.

What if I have a medical history that is less than perfect?

This is not uncommon.  We will take the time to understand the complete picture and then work with the underwriters that we have long-standing with to secure you the best offer.  Because of our experience and the volume of business that we write, it is not uncommon for us to get offers that others are unable to.

How much does disability income insurance cost?

it depends based on your state, medical specialty, age, gender, place of employment and medical history.  Lastly, it depends on the amount of coverage you need to secure and what benefits are important for you to include in the contract.  Give us a call to speak about this further (914) 372-2963.

How long does it take to secure a policy?

It can take anywhere from a day to a couple of weeks.  There are several factors that determine this which we would walk through when we complete the application with you.

An Individual policy - is a contract between you and the insurance company. Such policies should be Non-Cancellable and Guaranteed Renewable, which means the premiums never change and are guaranteed level. The policy can never be canceled, contractual provisions changed, or exclusions added so long as the premiums are paid. This type of policy should be the foundation of your disability protection.


Association plans - are contracts between the insurance company and the Association. Premiums increase, and the premium schedule and any policy provisions are subject to change. Partial disability benefits are typically only paid after total disability benefits. This eliminates coverage for virtually all illnesses. The insurance company can cancel the policy at any policy renewal. Due to the uncertain nature of these policies and more restrictive policy provisions, Association policies should only be used to supplement individual policies.


Group long-term disability (GLTD) plans - are usually provided by and paid for by your employer, and therefore any benefits received are taxable income, unlike Individual or Association policies. Again, contractual provisions are restrictive, and the policy is subject to ERISA. This basically means if benefits are denied you are forced to exhaust an administrative appeal process before taking legal action. If the insurance company loses a suit, it is only required to pay what it would have originally paid for the claim. If you change employers, the policy does not go with you. The coverage amount is generally based on your base pay and up to a defined cap.  As a result, group policies should also be used as supplements to individual policies.


The Gap

Many people know the group long-term disability (GLTD) benefits made available to them in the form of a company’s employee benefits package will pay a portion of their income should they become disabled.


Of course, the difficulty for many people

is correctly identifying what the portion of income covered under the GLTD benefits actually is. Knowing the actual benefits that would be paid, what income is covered, and which benefits are, and are not taxable, is the first step in identifying the “gap” in your disability income insurance (DI) coverage.


A review of your current employee benefits and income from all sources will help you determine how big, or how little, this “gap” is.