Tuesday, December 9, 2008

Own Occupation Benefit

The most frequently asked question I hear from doctors looking to purchase a disability insurance policy is, "Do companies still offer disability insurance policy's for physicians which protect them in their medical specialities with the own occupation benefit rider?

Yes, this benefit rider is currently available in all states, but only a few insurance companies offer these comprehensive own occupation disability insurance plans to physicians today. The true "own occupation" benefit rider is the most important policy feature for a physician to have in his/her policy. Why? Because it is the definition of total disability which determines whether or not you will be paid a benefit.

What should a physician look for in a comprehensive disability insurance policy?

When you are reviewing a group, hospital, association or individual disability policy, you should immediately go to the section , Total Disability, and carefully read the definition, as this will describe under what terms you would be eligible for benefits in the event of a total disability. A comprehensive plan example should state: "you will be considered totally disabled if , solely due to injury or sickness, you are not able to perform the material and substantial duties of your occupation, even if you are gainfully employed in another occupation." A comprehensive true own occupation policy should be very clear.

What is an example of a disability insurance policy that does not offer own occupation?

The marketing materials and illustrations for disability insurance policy's from many associations, group hospital plans and some individual plans often give the perception of an own occupation benefit policy by using terms like "protecting a physician in their medical speciality or occupation", in the event of a total disability. However, a closer analysis of the underlying terms in the specimen policy will show that it does not offer the true own occupation benefit rider with respect to total disability. These policy's may state:

"you are totally disabled if, because of injury or sickness: you are unable to perform the substantial and material duties of your regular occupation; and you are not at work in another occupation"
"you are not engaged in any other gainful occupation in which you could reasonably be expected to perform satisfactorily in light of your education, training experience, and physical and mental capacity.

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