Reasons Youll Be Denied
Since you never know if your insurance company is going to grant your request, you should apply early. Furthermore, you should understand the potential reasons why your insurance company may deny your claim. One of the main reasons theyll deny your claim is a change in the definition of disability. Or, the insurer may believe that your case does not meet the definition.
Other reasons include insufficient medical information, failure to receive medical care, misrepresentation on the application, non-compliance with treatment, pre-existing medical conditions, or surveillance. If you receive a denial letter, you should not stop. You always have the option of appealing. Appealing their decision may feel like an uphill battle but you can help. You should file a claim and provide the insurer with new medical information.
Make sure that youre truthful on the claim and provide the latest information about your disability. With a little luck, youll be able to convince the company to grant your request.
How Do I Get Individual Disability Insurance
If youre self-employed, your employer doesnt offer disability insurance, or you want to supplement the policy your employers does offer, you can apply for an individual disability policy. Individual disability insurance elimination and benefit periods may differ from group disability insurance, but a financial representative can help you choose the right coverage for your situation. If youd like some help understanding what type of coverage makes sense for you and applying for a policy, get in touch with a financial representative who can help you make a decision.
Individual disability income products underwritten and issued by Berkshire Life Insurance Company of America , Pittsfield, MA. BLICOA is a wholly owned stock subsidiary of The Guardian Life Insurance Company of America , New York, NY. Product provisions and availability may vary by state.
Links to external sites are provided for your convenience in locating related information and services. Guardian, its subsidiaries, agents and employees expressly disclaim any responsibility for and do not maintain, control, recommend, or endorse third-party sites, organizations, products, or services and make no representation as to the completeness, suitability, or quality thereof.
What You Should Actually Worry About With Your Long
You donât need to worry about a probationary period with your disability insurance, but that doesnât mean there arenât other things to consider. Besides the elimination period, hereâs what you should focus on.
Whatâs the definition of disability? A disability is what defines whether you are eligible for a claim. It largely has to do with the type of occupation status your policy has. A true own-occupation policy means that youâll receive the disability benefit if you canât work your own job, even if youâre able to do other work.
Whatâs the benefit period? Benefit periods â that is, how long you receive the benefit â can range from two years all the way until your retirement.
Whatâs the benefit amount? This is how much money youâll get each month from the insurer. The typical benefit amount is 60% of your take-home pay.
These items affect the cost of your policy. If you have a strict definition of insurance with a long benefit period and high benefit amount, that will raise the price. Together with the elimination policy, these factors determine how much your long-term disability policy costs.
In the end, there are more important things to worry about when it comes to long-term disability insurance than the probationary period . The elimination period is the real key to determining when your benefits start, and it should be part of your search when protecting your income â and your family.
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Do Retroactive Salary Increases Affect The Calculation Of My Disability Insurance Benefit
In accordance with the Disability Insurance Contract, the retroactive salary increase provision applies only to claimants whose disability commenced on or after March 1, 1993.
Any retroactive salary increase approved after the commencement date of your Disability Insurance benefits will affect your insured salary and benefit level only when the effective date of the increase precedes the date your DI benefits began. Therefore, a retroactive salary increase approved in April, to take effect from February 10, would only be used to adjust benefits if your DI benefits commenced February 11 or later
Benefit Periods For Individual Plans Vs Group Plans
Private disability insurance is sold in two ways: through workplaces and other groups called group insurance, and through insurance agents to individual consumers. This second type is called individual disability insurance.
Each type has pros and cons. They calculate benefits differently and may have different benefits periods and waiting periods.
Group vs Individual Disability Insurance
|Short Term: Less than one yearLong Term: From two years until retirement||Pros: If you’re at high risk for disability, pooling coverage with others can be cheaperCons: Limited options; you lose coverage when you switch jobs|
In short, group coverage provides safety in numbers, lowering your premiums if youre older or have other risk factors , but it can also cause you to lose out on better deals that you could qualify for individually.
Plus, youll lose your group coverage every time you change jobs which could mean that youll be left without disability benefits when you need them most.
If you just cant choose between one or the other, you may be able to purchase a smaller amount of both types of coverage some through your workplace and some individually and get the best of both worlds.
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What Is The Elimination Period For Short
Short-term disability insurance may have no elimination period. If it does have a waiting period, its typically between 1 week and 90 days. After the elimination period, coverage lasts from 3 months to 5 years, depending on your policy.
Short-term group policies usually have longer elimination periods than short-term private policies. Once they take effect, they also tend to pay benefits for a shorter time than private policies do, which is rarely more than one year.
How Does It Affect Payout
You will not receive your disability insurance benefits until the elimination period is over. Once it passes, benefits are paid out, typically on a monthly basis, until you are able to go back to work or for as long as the policy dictates. In most cases, disability insurance pays between 40 percent and 80 percent of your income once the elimination period is met depending on your policy.
Example Of The Disability Insurance Waiting Period
Lets say you have a 60 day waiting period. You are an auto mechanic. On weekends, you like to work on your lawn and garden. Neighbors say you have the best curb appeal on the block!
One day you are walking in your yard, examining your grass. Unexpectedly, you step into a hole and turn your knee awkwardly. Theres shooting pain, but then the pain goes away. You get up and walk it off. You have some pain throughout the day, but you take ibuprofen and dont think much about it.
Until the next morning.
You are in pain. You cant move your leg. Your wife drives you to urgent care when they take an MRI. You tore your MCL and ACL. The doctor is surprised you didnt have much more pain.
You cant work. You wonder what you will do. Then, you remember the disability insurance policy you have. It will pay $3,000 per month. Your primary doctor fills out the disability paperwork and you submit the claim.
The carrier approves your claim. Here is what the timeline looks like:
Recurring Illness Or Injury
But what happens if your health improves, you return to work, and your injury or illness returns?
Lets say you suffer an injury or illness and qualify to receive benefits. You endure the elimination period. You start collecting benefits. Then, your health improves, and you return to work. And then your illness or injury returns.
In the scenario above, most insurers will not make you wait out the elimination period again. Cancer patients who undergo treatment and then have their cancer return are a good example of patients in this group.
If your injury or illness is the same as the one you qualified for already, youll only have to wait out one elimination period. If its a completely separate issue, the elimination period will go back into effect and start over.
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Di Premium Rate Increase
Each year, the DI Board of Management reviews the financial operation of the Plan. Based on this review, the Board, through the National Joint Council Executive, makes a recommendation to the President of the Treasury Board regarding the premium rate necessary to ensure that the plan is financially sound and continues to operate in the best interest of plan members.
are done so in accordance with the information in this notice.
What Is A Disability Insurance Benefits Period
A benefits period is the length of time you are eligible to receive benefits . How long your disability insurance benefits period will be depends on whether youre accessing government or private benefits.
If you have private disability insurance, it will also depend on whether you purchased long-term or short-term disability insurance , as well as on the specific details of your policy.
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Elimination Periods And Long
Before buying LTC insurance, make sure you know the terms of the elimination period. Most policies require policyholders to need consecutive days of services or disability.;
For example, if your elimination period was 90 days, you would need to be in a hospital or disabled for 90 consecutive days before any coverage begins. Accumulating 90 days in total over a specified period of time would not qualify you for coverage.
Reasons Why The Disability Insurance Elimination Period Is Important To Understand
An agent talks to you about disability insurance, but then mentions the elimination period or waiting period.
Your eyes glaze over and that stops you from proceeding. Or, you briefly discuss it, and then you have a wrong impression of how it works.
Then, you will have a major misstep down the road if you ever file a claim.
In this article, we discuss the disability insurance elimination period, but more importantly, why it is important for you to understand.
If you understand how the elimination period works with disability insurance, I guarantee you will likely save money.At a minimum, however, you will have a better understanding to make an educated decision on the right plan structure for you.
Here are the section links for easy navigation:
Lets jump in and clearly define the elimination period.
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Elimination Periods Available On Leading Policies
Here is an overview of the elimination period options available on the leading disability insurance policies for physicians:
Ameritas’ disability insurance policy for physicians offers elimination period options of 30 days, 60 days, 90 days, 180 days, 365 days, and 730 days.
Guardianâs disability insurance policy is available with the following elimination periods: 30-day, 60-day, 90-day, 180-day, 360-day and 720-day.
MassMutual policies offer elimination periods of 60 days, 90 days, 180 days, one year and two years.
Ohio National offers coverage with 60-day, 90-day, 180-day, and 365-day elimination periods.
Principal allows you to purchase coverage with 30-day, 60-day, 90-day, 180-day, and 365-day elimination periods.
Standardâs disability coverage comes with 60-day, 90-day, 180-day, and 365-day elimination periods.
The American Medical Association’s group plan offers 60, 90, 180, and 365-day elimination periods.
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Reason #2 Why Its Important To Understand The Disability Insurance Elimination Period You Can Save Money
If you understand the disability insurance waiting period, you can save money.
Think of the elimination period and the premiums as a see-saw. The lower the waiting period, the higher the premium, and vice-versa. All things being equal. See below for an illustration.
All things being equal, the lower or shorter the waiting period, the higher or more expensive the premiums. Why? Because you are receiving your benefit quicker.
With most carriers, the most economical price-point is a 90-day waiting period.
But, John. I need a lower waiting period. I need my money fast.
Is a lower elimination period right for you? Well, that depends. And, it depends on how much money you have saved.
You see, if you have a disability in the short-term, ideally that disability should be covered by your savings.
Families run into serious financial trouble after 3 or 4 months of no income. That is why long-term disability insurance makes sense.
However, short-term disability insurance which typically has a 3 or 6-month benefit period does not. It can be incredibly expensive, which is why we believe short-term disability insurance is a waste of money.;
If an agent or agency is telling you that you need short-term disability insurance, you have to question why. What you really need to do is buckle down on your spending and save that money.
Heres an example of comparing the premium costs on a long-term disability insurance policy with different waiting periods. Youll see what I mean.
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What If I Have A Recurring Disability Or A Pre
If you have a pre-existing condition, the insurance provider is going to ask you questions about it during the application process. With a pre-existing condition, its common to see an exclusion but you may be able to get a short reconsideration period where the exclusion is reconsidered. This usually requires that there have been no further symptoms or treatment for a period of time.
A one-year waiting period is considerably longer than the 0-90 day period granted to someone without a pre-existing condition. Yet its one of the best ways for insurance companies to protect against people who try to make a disability claim on an already existing issue. By opting for a longer elimination period, you may be able to get an insurance company to make a more favorable offer to you in light of your health history.
When You Will Receive Your First Ltd Check
Most LTD plans have a service wait, which is a set period of time before coverage actually begins. If you have a pre-existing condition exclusionary period, it starts after the service wait ends. When the service wait and exclusionary period are over, you are eligible for a benefit.
The date when this happens is called the coverage effective date.
Once you apply for a benefit, there is usually a waiting period before you can begin to receive benefits. This waiting period generally lasts between 30 and 180 days. Shorter or longer waiting periods are available under some LTD policies. Usually, the longer the waiting period, the lower the premium will be.
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Picking The Right Elimination Period
Everyone has a different financial situation. Therefore, everyone may need a different elimination period for their insurance policy. For example, if your employer offers a short-term disability plan, the elimination period should coincide with a short-term disability plan. Additionally, your long-term disability insurance should pick up where your short-term disability insurance trails off.
For those who have an emergency fund of six to 12 months of their expenses set aside, they could consider an insurance policy with a longer elimination period. If you have enough money to pay for your disability expenses or long-term care needs, you may be able to save money on your insurance premium. You could consider a 180-day elimination period, which would provide a smaller premium amount.
On the other hand, if you dont have a large emergency fund, select an insurance policy you can afford. Even if it has a longer waiting period, you can start saving money to afford any additional costs you may incur. This way you wont have to stress about making your monthly insurance premium payments.
What Are My Obligations With Respect To My Claim
While you are receiving benefits, you must be under the regular care of a licensed physician and following a course of treatment, which, in the opinion of the Insurer, is appropriate. You must also make every reasonable effort to comply with recommended treatment modalities which may facilitate your return to your employment during the first 24 months of disability or to obtain employment in a commensurate occupation at the end of the 24 months of disability.
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Riverside Social Security Disability Attorney
As you wait through the elimination period, you may be leaning on your liquid savings or short-term disability benefits to make ends meet. Should you need any assistance or have any questions about accessing disability benefits, the team at Disability Advocates Group is here to help. Contact us today.
The Risk Of Choosing Lengthy Elimination Periods
Choosing anything higher than 120 days means that in exchange for a slightly smaller premium payment, you will be spending your own money for a much longer period if you do become disabled.
Buying a physicians disability insurance policy with a longer elimination period is like buying an auto or homeowners insurance policy with a higher deductible. In both cases, the policy holder is simply trying to save a few dollars now with the mindset that they will never have to file a claim. But if the worst happens, they may wish they had paid the higher premium because of the out-of-pocket costs before insurance benefits kick in.
If youâre considering a longer elimination period, estimate how long you will have to cover your lost income before benefits kick in. Then determine whether you have enough in savings and investments to cover that out-of-pocket cost, and whether you want to use that much of your own money. You should avoid choosing an elimination period longer than how long you could afford to support yourself after you become disabled.
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