GROUP VS. INDIVIDUAL DISABILITY
WHAT’S BEST FOR YOU?
Insurance choices can be confusing, to say the least. It’s not exactly the way you want to spend a Sunday afternoon, pouring over the pros and cons of group vs. individual disability policies. However, it is a necessity as 20% of the American workforce becomes disabled at some time during their careers.
Up front you must know that individual plans will be more expensive than group plans, so if money is an issue, you may just want to stick with a group plan. However, individual plans offer some benefits that make the extra costs well worth it. It is up to you to decide.
Here are some key points to look for that may help you in your investigation:
1. Individual policies purchased from an agent or brokers carry the strongest consumer remedies. If the carrier wrongfully delays you are entitled to a jury trial and depending on your state emotional distress damages, extra-contractual damages and in some states punishment damages. If you pay the individual policy premium personally, not from your corporation the benefits are tax free. Group policies are generally taxable, contain no real remedies as there is no jury trial, no damages for wrongful delay and before you can sue you need to administratively appeal the group insurers’ wrongful denial.
2. Is the premium guaranteed to remain the same price through age 65? This is important, as you want to be able to afford your insurance in the coming years. If the premiums get too high, you may not be able to afford them and a lapse in premium payments means you lose everything you have put into it up to that point. Not to mention the fact that you no longer have coverage and depending on your age, you could be looking at a much higher premium even if you get another company to take you as a client.
3. Look at all clauses that detail exclusions carefully. Are things like mental health and nervous disorders covered? If so, are they paid for one to two years or are they covered up to age 65?
4. Make sure the policy is “own occupation.” If it is, then you will be covered in your own occupation – the one you are trained and educated to perform. Should you become disabled and not be able to perform the duties of your own occupation, you will receive benefits, but you may still be able to work at something else. For example, you may not be able to perform brain surgery, however, you can teach medical students. You can still be productive and earn some income while receiving your tax free disability benefits.
5. Check to see that your policy has some inflation protection and also that you can add benefits as your income increases over the years without evidence of insurability.
6. Ideally, you would like to have a policy that is “non-cancellable.” You’re carrier can’t cancel your policy as long as you timely pay your premiums.
7. If you have to file a claim, remember most group plans fall under the federal Employee Retirement Income Security Act (ERISA). These claims must follow the Department of Labor rules instead of state insurance law. They are harder to litigate should your claim be denied.
8. Pick a waiting period that fits your budget. If you can afford to pay expenses for a while and can set the benefit date out six months to a year, you will experience lower premiums. Be sure to look for a “waiver of premium” clause so that you will not be bound to paying premiums while you are disabled.
Finally, should you find yourself in a position where you have to go to battle with the insurance company because your claim was denied; a Long-Term Disability Appeal should be handled by a Long-Term Disability Attorney. Long-Term Disability Attorneys are specifically trained to handle all the details of Long-Term Disability Appeals and they have run the race before. It is their experience that will help you to be successful and will relieve you of the stress involved so that you can recuperate more quickly.
Remember, most group policies require a time sensitive administrative appeal and you must prove in that appeal the carrier was wrong beyond the reasonable doubt standard. Most claimants make fatal mistakes during the administrative appeal that can be averted and avoided if they had hired a Long-Term Disability Attorney.
Tags: Damages For Wrongful Death, Employee Benefits Lawers
Damages For Wrongful Death Employee Benefits Lawers
