Own Occupation AKA, the "Double Dip"

We know your work is your passion and that you’ve worked assiduously to get where you are in your medical career today. Chances are you’re working way over 40 hours each week and really don’t see yourself slowing down any time soon. What do you do if an unforeseen disability were to do just that -- slow you down?

The Own Occupation rider comes into play if you were to become consequently totally disabled; this rider (note: depending on the insurance carrier and contract, it may be built-in already) allows you to go work in any other occupation you choose and still receive 100% of your disability benefits, so you can “double dip” essentially.

In order to be considered “totally disabled” it must be determined that you are unable to perform the material and substantial duties of your occupation/medical specialty. Your occupation is what you are doing at the time a disability begins. For example, if part of your practice is performing the duties of an OBGYN (C-sections, delivers, sonograms, well woman exams, Paps, etc.), then all of those duties are considered to be “your occupation”.

To illustrate how this “double dipping” would work, let’s imagine that our example OBGYN has been involved a disastrous car accident; she is now in a wheelchair and has not been able to go back to work in over 3 months. With no official recovery date in sight, her healing is slow yet steady. She is itching to get back to work in some capacity but is not able to do the material duties of her occupation. The Own Occupation rider gives her the freedom and option to go back to work in another occupation if she chooses and is able to do so, while still being paid 100% of her disability insurance benefits. Even though she is working in another occupation, she is still considered “totally” disabled by the insurance carrier because she is not able to perform the material and substantial duties of her occupation (OBGYN).

Take charge of your disability.  Get paid in another occupation while you focus on getting back where you want to be –back on your feet and doing what you trained for and love.

Contact us today to learn more!

The Standard’s Compassionate Disability Benefit

As physicians who take care of others day in and day out, you understand more than anyone that injury and sickness are not discriminatory; it can happen to anyone at anytime. (One of the many reasons you know the value and vital need of owning a disability insurance policy.)

What if something adverse were to hit a little closer to home and affected your Loved One? Chances are you would cut back your working hours in order to help take care of them. Insurance carrier, The Standard recognizes this possibility and they have a built-in provision in their contracts called the Compassionate Disability Benefit. This means The Standard will pay a benefit while:

• You are working at least 20% fewer hours in order to care for your Loved One while he or she has a Serious Health Condition which began after your Policy Effective Date and before the Termination Date; and

• Your Monthly Earnings are at least 20% less than your Predisability Earnings due to that reduction in hours worked; and

• You are not Disabled; and

• No other benefit is payable under this policy.

Loved One means your parent, child (including an adopted child and stepchild), spouse, Domestic Partner, and child of your Domestic Partner.

Serious Health Condition means that due to your Loved One’s Injury or Sickness, he or she:

• Is receiving inpatient care in a hospital, hospice, or residential medical care facility; or

• Requires Substantial Supervision for his or her health or safety due to Severe Cognitive Impairment; or

• Is unable to safely and completely perform two or more Activities Of Daily Living without Hands-On Assistance or Standby Assistance due to loss of functional capacity; or

• Is terminally ill with a condition that is reasonably expected to result in death within 12 months.

 You may claim the Compassionate Disability Benefit up to two times while your policy is in force. The maximum amount of Compassionate Disability Benefit The Standard will pay for all claims and all Loved Ones is a total amount equal to six times the Basic Monthly Benefit.

The Compassionate Disability Benefit will begin once the Benefit Waiting Period is met. The amount of Compassionate Disability Benefit they will pay each month will depend on the amount of your Monthly Earnings.

If your Monthly Earnings are:

• Less than 20% of your Predisability Earnings, the amount The Standard will pay will equal the Basic Monthly Benefit.

• 20% to 80% of your Presdiability Earnings, the amount they will pay will equal a portion of the Basic Monthly Benefit. To calculate the Compassionate Disabiltiy Benefit for each month:

  1. Subtract your Monthly Earnings from your Predisability Earnings

  2. Divide the result from step 1 by your Predisability Earnings

  3. Multiply the result in step 2 by the Basic Monthly Benefit

• More than 80% of your Predisability Earnings, no Compassionate Disability Benefit is payable.

As a physician, you realize family and health are two of the most important and precious things in this world. By offering this no cost, built-in provision, the Standard takes care of you so when your family needs you most you can take the time to focus on them.

A Supplemental Health Benefit to Your Physician Disability Insurance

Accidents are NOT usually main the culprit of disabilities. Illnesses like cancer, a heart attack or diabetes cause the majority of long-term disabilities. Back pain, injuries, and arthritis are also significant causes. The insurance carrier Principal Financial Group, takes your income protection even further with a unique, built-in provision called the Supplemental Health Benefit. How's how it can help.

How It Works

The Supplemental Health Benefit provides a once in a lifetime lump sum 6 times your monthly benefit if you were to become disable under the policy and are diagnosed with Coronary Artery By Pass Graft Surgery, Cancer or Stroke. These are defined as:

• Coronary Artery By Pass Graft Surgery – Means the operative procedure for the correction of two or more blocked arties of the heart. This does not include angioplasty and/or any other intra-arterial procedures.

• Cancer – the presence of a malignant tumor characterized by the uncontrolled growth and metastasis of malignant cells, and the invasion of tissue. Includes: Leukemia and malignant melanoma. The following diagnoses are not covered; any non-invasive cancer in-situ, Hodgkin’s disease Stage 1, prostate cancer Stage A, papillary cancer of the bladder, all skin cancers except invasive malignant melanoma (starting with Clark Level III).

• Stroke – Any cerebrovascular incident producing neurological deficit lasting more than 24 hours and including infarction of brain tissue or hemorrhage into brain tissue. Evidence of neurological deficit for at least 90 days must be produced.

This benefit is included in your policy at no cost to you as a policy holder because the provision is built directly into Principal Financial Group’s contracts. Should you consequently become disabled and the disability is characterized by one of the above defined diagnoses, then you will be paid the lump sum in addition to your base policy coverage. 

To learn more about this benefit and how it can supplement your contract specifically, please contact us today!

Total Disability Defined

Total Disability Defined: Private Insurance vs. Typical Association Plan

How is total disability defined? To put it simply, what would need to happen in order for you to receive (and continue receiving) benefits under your disability policy and what are the terms and conditions that must be met in order for you to get paid? This is where things can get tricky.

Medical Association Disability Policies

Under most medical association plans, a typical definition of disability may read: “We will consider you totally disabled if an injury or sickness prevents you from performing the substantial and material duties of your occupation. Your occupation is what you were doing at the time a disability begins. After benefits have been paid to you for 60 months, we will consider you totally disabled IF you cannot perform any reasonable occupation based on your education, training, or experience.” This is where the underwriting carrier of a medical association plan can “manipulate” your income benefits. If they feel, in their medical opinion (which conveniently comes from an employee of the insurance company) that you can indeed perform a “reasonable” occupation based on your education, training, or experience, then you are no longer considered “totally” disabled—they may still pay you “partial” benefits based on a complicated formula. The biggest issue with this type of policy is that it takes away the decision from you.

Private Disability Insurance

A private disability insurance (i.e. individual disability insurance) definition of total disability differs dramatically from a Medical Association carrier’s definition. Assuming you have wisely purchased an Own Occupation definition of disability policy, the carrier does not have the flexibility that a medical association carrier does.

The private carrier cannot come back to you either during the first 60 months of benefits OR afterwards and assume you can go work in a “reasonable” occupation. It is your own choice to work in another occupation, or to not work. If you choose to work in another occupation, you will not be penalized or have your benefits reduced—again, assuming you have the own occupation definition of disability.

The Situation

Let’s consider the scenario where a surgeon, let’s call him John, develops a disability, a motor neuron disease in his dominant hand. Depending on the severity of the disease, this can render John incapable of performing his skillful duties as a surgeon indefinitely.  However, the medical association’s insurance provider could consider John fully capable of doing something else in an occupation within the medical field, based on John’s background, experience, education and training. In other words, when the 60 months of disability expire, John may no longer be eligible for full disability benefits. This is very problematic, especially if John cannot find the work that the insurance carrier expects him to be able to perform.

Probability and Disability Polices

It is important to remember that insurance carriers are not benevolent.  To them it’s a numbers game. For instance, consider the same surgeon, except now he specializes in micro discectomy surgeries. John now wears a 20-pound scope (needed for surgeries) on his head and his neck is bent at an angle 9 hours a day. While it doesn’t seem like much at first, in the long run it will have drastic wear and tear on his neck, upper and lower back, potentially leading to a bulging or herniated disc. This type of injury accounts for over 20% of disability insurance claims. Conveniently (inconveniently for you), medical association plans typically have a 2-year max benefit on musculoskeletal issues…a numbers game. You wouldn’t get a car insurance policy that excluded accidents with teenagers, but a car insurance provider might require this if you lived by a high school.

Conclusion

When you are choosing your disability policy ask yourself this: “If I had my medical gift and skill set taken from me through an injury or disease, would I want to control how much I get paid monthly, or would I want the insurance carrier to dictate that to me.”

It is as simple as that. 

Disability Insurance with a Money Back Guarantee?

That's Right! If you don't use your disability policy benefits for either Total Disability or Partial/Residual Disability, the carrier will refund you 50% of your premiums every 5 years.

This may be a perfect opportunity for those physicians who say “I'm never going to become disabled," or " I don't want to waste my money on disability insurance premiums".

With the Return of Premium Rider, (yes there is an additional premium required for this benefit) you can still protect your income and your lifestyle, but if you never become disabled, you get half of your premiums back. It's a WIN/WIN!!

But what happens if you do become disabled and you are unable to perform your medical specialty any longer due to a sickness or an injury? Well then you have your disability insurance benefits to rely on. You are still OK. However under this rider, you would only be refunded your premiums if the premiums you have paid exceed the disability benefits you have received. Also if you cancel your policy during the 5 year period you do not receive any premium refunds.

Given the fact that you may never use your disability insurance benefits, wouldn't you like to get a substantial check back every 5 years? You decide, but let's talk about it. Call me at (800) 729-6929. (This rider is N/A in the following states: CT, FL, NJ, NY, OR, PA and TN)