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Long Term Disability ERISA and Private Disability Insurance Claims

6/30/2009
Nancy L. Cavey
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Shopping for a physician and dental disability insurance.

Physicians and dental disability insurance can help protect medical providers and their families in the case of injuries or unexpected circumstances. You and your family rely on your paycheck to pay bills, feed and clothe your family, and to provide a home and a lifestyle that have come to expect.

There are a number of things that you should consider before choosing a disability insurance policy. At Cavey & Barrett, we recommend that physicians and dentists purchase private disability insurance policies instead of a policy through a group plan. You should consider the following:

1. Quality. This disability plan will be the main source of your monthly income if you're disabled and are unable to work. The amount of the monthly income that you will be paid has to be high enough to cover all the bills that you need paid every month. Therefore, the plan that you select should cover your monthly expenses.

2. You should also have a guaranteed renewable feature, which means that as long as the premiums are paid the insurance company can't make any changes in your policy. A disability policy can't be cancelled for any kind of reason, including changes in your health. So long as you continue to pay the premiums, you have disability insurance coverage.

3. Company rating and status. Insurance companies should be financially sound to provide you with security, and you want to enroll in a plan that has a rating of A+ or better. However, company ratings aren't the most important factor. At Cavey & Barrett we find that many disability insurance companies that have high ratings have lousy track records in paying disability claims. Be sure that you ask your disability insurance agent about the claims paying and denial history of the company that they are recommending.

4. Benefits. When deciding on a disability insurance policy, you should consider the amount of the monthly benefits and how long you must wait before you get those benefits. Many disability insurance companies will offer to only pay 50 to 60 percent of your income, and it is rare that you will find a disability insurance plan that will pay 100 percent of your income.

5. How will you make up the difference? Many long-term disability policyholders mistakenly believe that Social Security Disability benefits can assist them in making up the difference. In some areas it will take over two years to get a Social Security Disability claim approved. More importantly, many group disability policies will have a provision that reduces the amount of your disability benefits by the receipt of your Social Security benefits.

6. Another important factor is what is called the elimination period of benefits. Most insurance companies will pay claims within 60 to 90 days after the disability period begins. How long can you go without a paycheck?

7. Coverage. When shopping for a disability insurance company, make sure that your specific occupation is listed, instead of a general occupational listing. In other words, if you are an interventional cardiologist, you want to make sure that you are covered for your loss of ability to work as an interventional cardiologist. Similarly, if you are a cosmetic dentist, you want to make sure that your specific occupation is listed instead of being listed as a general dentist.

8. Shopping for physician and dental disability insurance companies can be confusing especially if you don't know what you are looking for. In Nancy Cavey's experience, getting a "medical, specialist or a broker" who can advise you on the best insurance company for your situation is helpful, but it is not the only solution.

9. Many medical providers have complex financial considerations that need to be evaluated in selecting the right disability insurance policy. These will be discussed in future postings.

Answering these broad-based questions isn't easy. Help is a phone call away. You can contact Nancy Cavey, an experienced long-term disability attorney at 727-894-3188.




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