Broker Check

Healthcare Professionals

002-medical 

Individual Disability Insurance - Important Policy Provisions:

1) Own-Occupation/Own Specialty:

The most important definition when insuring someone in a highly specialized medical occupation. For example, if a surgeon can no longer perform surgical procedures but can return to work full time as a general practitioner, he still qualifies for full disability benefits under the Own-OCC/Own-Specialty provision. There are various levels of choice with this definition such as True own occupation / own specialty, Transitional own occupation, and Modified Own Occupation.

 2) Non-Cancelable/Guaranteed Renewable:

These two related provisions give the insured total control over the policy. The insurance company cannot raise rates, reduce benefits, or add exclusions after the policy is in force. This provision also extends the presumptive disability benefit to life of contract duration such as to age 65, 67, 70 or lifetime.  As long as the insured pays the premiums on time (with in the grace period), the insurance company can't cancel the policy, change or down grade the contract technical language, or raise the pricing. 

 3) Residual/Partial benefits:

Policies pay residual benefits whenever income is reduced by 20 percent or more with a loss of time or duties due to disability. For example, if an Emergency Medicine Physician earned $400,000 annually, was disabled and then returned to work earning $200,000 annually, she would have a 50 percent loss of earnings, and thus qualify for a 50 percent residual benefit.

 4) Future Purchase Option Rider:

The future purchase option rider allows the insured to buy additional monthly benefits on specific option dates. This is regardless of the insured’s health, as long as the earned income at the time justifies the increase of benefits.


Factors affecting premium rates:

  1. Medical specialty (invasive vs. non-invasive)
    • Most companies charge higher premium rates for invasive medical specialties. We represent all the finest independent industry leading disability carriers for healthcare professionals. We are brand neutral, and provide you with the best in product choice. We educate you in a no-pressure, educational format and provide you with "Good, Better, Best" solution comparisons. No one company fits all medical specialties the best. We are very well versed with the different insurers' contract strengths and weaknesses. Many limit mental nervous/stress related coverage to 24 months for certain occupations. We provide you objective and professional due diligence in our recommendations.
  2. State of residence
  3. State of issue
  4. Gender (female rates are higher due to much higher claims ratios). LMFS advisers are able to eliminate this pricing barrier by offering group, multi-life, multiple-policy, and association discounted pricing for your medical specialty
  5. Age
  6. Health status
  7. Discount programs (Multi-Life, Multi-Policy, Group and Association Options)
  8. Policy riders quoted
  9. Type of policy
    • Up to 50% of disability insurance policies are not approved as applied for. Medical history and avocations can lead to policies that contain exclusions.
    • Typically, the annual premium of a very good disability policy equals to 1-3% of annual income. To cover a $200,000 income costs $2000+ per year.