Glossary of Dentists Disability Insurance Terms
Terminology Of Disability Insurance For Dentists
The length of time (window) where the elimination period or waiting period would need to be filled if days are not consecutive. It would be very probable where an insured dentist would be in and out of work being able to “accumulate” their days out of work to reach the specified waiting period, thus triggering a disability insurance claim. Usually, the longer the elimination period, the longer the accumulation period.
This is a hybrid of group and individual coverage. Many dental associations across the country have created such plans to attract new members to their respective associations and add value. These plans are typically guaranteed renewable plans requiring membership fees to maintain the association coverage. The premium for such plans are age banded (increase in cost as the dentist ages) and can increase on an unscheduled basis. It is never a good idea to have all of your disability coverage in such a plan simply because they are fairly volatile in premium and usually lack strong quality verbiage to maintain lower premiums.
The length of time a disability benefit would pay if disabled, typically to age 65 or 67. Some plans are still issuing benefits periods of LIFETIME; a benefit would pay as long as you are alive and disabled.
Pays the overhead of a dental practice if disabled so that the dentist doesn’t have to use their savings or disability benefit to pay the bills. These plans have shorter benefit periods of 12 to 24 months, dovetailing with pre-established practice agreements or long term leases, and allowing enough time for the disabled dentist to determine if he or she is going to recover or needs to dissolve the practice after health status is firmly determined.
A term used to describe the immediate activation of disability insurance coverage in exchange for a premium assuming medical requirements are met, and all underwriting qualifications are met. If the insured becomes disabled in this window of time before approval of a policy, the benefit would be paid (assuming the definition of disability is met) if health status before the claim would have permitted approval of a policy.
An enhancement to a disability plan that would increase the monthly benefit by the CPI not to exceed a ceiling of typically 3% or 6% compounded or simple interest per year during a claim. This would only be triggered during a claim, so it becomes important to keep disability benefits up to date through annual reviews. This rider is designed to prevent inflation from eroding at your benefit.
The length of time a dentist would need to be disabled before entering into a disability insurance claim scenario. The longer this period, the lower the premium since this essentially is a deductible.
This details the risks the insurance company wouldn’t cover a dentist for, resulting in no benefits paid. Most carriers commonly exclude disabilities from war and mental and nervous disorders. There are still a few companies willing to not exclude any mental and nervous disorders.
This allows a dentist to expand their disability policy by the amount purchased without having their health re-examined by an insurance company on the anniversary date. This is a very important rider for newer dentists wanting to protect a projected larger income since their health status could change, making them ineligible for increased coverage without this rider. A dentist would still need to prove their larger income through W-2s and/or tax returns to qualify for the increased coverage.
Disability coverage that covers a group of dentists. Usually, “initially” inexpensive since the definitions and premiums can change on an annual basis. Most of these plans are not portable to a new occupation or practice.
For larger dental groups, some insurance companies are willing to issue individual disability insurance without having to place a dentist through medical or financial underwriting. With larger pools of dentists, an insurance company will consider such an offer to avoid adverse selection. Adverse selection is an undiversified group of risk removing normal statistical risk profiles.
A characteristic of a disability plan that prevents the insurance company from changing the definitions or canceling the plan. They do reserve the right to change the premium for a given class of insureds. Most association group coverage is guaranteed renewable.
A plan to protect a dentist’s income from an injury or sickness. Usually, these plans are fully underwritten, meaning a dentist would need to prove their health and income to be an acceptable risk to the insurance company. Once activated, these plans are usually guaranteed never to change in premium or definitions for the life of the policy.
The amount of monthly benefit an insurance company would be willing to place on a dentist with a specified income. Each insurance company sets its own issue limit for a given dental specialty and income.
A less liberal definition of “own occupation” language where a benefit would be paid as long as the dentist is unable to perform the material and substantial duties of their occupation and isn’t by choice working in another occupation. If the dentist elects to work in another occupation, then the new occupation income would offset the disability benefit by a predetermined formula.
The amount of money paid to a dentist that has met the definition of disability for the respective insurance company.
A characteristic of an individual disability plan that prevents the insurance company from changing the premium or definitions for the length of the benefit period.
A term used to describe the more liberal disability contracts available to dentists. With “own occupation” language, if a dentist cannot work in his or her occupation because of sickness or injury, then they would receive a monthly benefit regardless if they were working in another occupation. There would be no offset from monthly disability benefits from earnings in a new occupation.
This definition is what triggers a claim if a dentist is not totally disabled but partially disabled. Every disability contract should have some form of partial disability rider verbiage.
The amount an insurance company will participate in the overall disability income protection program for a dentist. An insurance company will participate at a higher level than it will actually issue on a dentist. The participation limit is set for each carrier and is further broken down by specialty. The participation limit would look at the total coverage from group, association, and individual coverage. Insurance companies work together through the use of participation limits to prevent a dentist from having more benefits than he or she actually has in income if we look at the NET disability benefit paid after taxes.
A condition affecting the probability of claim being paid whereas the insurance company is unwilling to cover since it was a health condition before the insurance was applied. This is something most common to the group disability insurance and guaranteed standard issue (GSI) insurance market.
A dentist would be presumed totally disabled if these conditions were met, even if they could work in some capacity. The loss of sight, limbs, or speech would be examples of a presumptive disability but differ from each insurance company.
The benefit an insurance company would pay a dentist who is recovering from a total or partial disability. It can come in the form of lump sums of money or a temporary richer payment of residual disability benefit. Since most disability claims end up in a residual payment, it is very important to understand how this rider would perform and compare it to alternate carriers.
In a given window of time, typically 6 to 12 months, if a dentist becomes disabled for like causes after being on claim, the elimination period would be waived, thus immediately entering into a claim scenario.
Insurance companies are willing to provide special rehabilitation benefits to assist a dentist in a better way of life during and after a disability. This usually helps the dentist get back to work sooner causing less grief on the overall financial picture and family.
Dentists in residency are eligible for a preset amount of disability coverage regardless of income, only needing to prove their health insurability to an insurance company to acquire coverage. This would be portable so that when they finish fellowship or residency, they have coverage immediately at the new practice setting.
Not totally disabled but the dentist has some loss of time or duties and loss of income, usually at least 20% but some will go down to only 15%. This is generally a more liberal definition than partial disability since you usually don’t have to be totally disabled during the elimination period to qualify. This is a rider available on all quality disability plans and should always be considered since a dentist might not ever be totally disabled only residually disabled.
Social security has a disability benefit if totally disabled but would require that a dentist is unable to perform ANY occupation to qualify for a benefit. The definition of being disabled for social security is the hardest to qualify for. A dentist can reduce the premium for their disability coverage if this rider is added since it would offset the benefit from the insurance company if social security benefits pay.
If the dentist didn’t qualify for social security but met the definition for the insurance company for a claim then there would be no offset. The disability benefit available through social security is dependent upon past income and will show on the annual social security statement.
When a dentist is unable to perform all the material and substantial duties of their disability policy definition of total disability then they would fall into a total disability claim resulting in full monthly benefits.
Under certain circumstances, the elimination period would not need to be met to enter into a claim scenario. This is typically after a dentist has entered into a claim scenario and later re-entered because of like causes.
If a dentist is being paid a benefit for being disabled totally or partially, the insurance company will waive the disability premium.