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There are two general philosophies of disability insurance marketed during the past
20-30 years. The first philosophy
insures you with a policy where “total disability” means your
inability, caused by an accident or sickness,
to engage in your regular occupation. “Regular
Occupation” is the occupation or occupations you were engaged in at the
time of disability. These types of
policies are commonly known as “own occ” policies.
At its most competitive end, “own
occupation” is specified or at least recognized by the insurer as a “specialty”
within medicine or surgery, dentistry, law and other professions.
Therefore, if you are disabled within your
occupational specialty but could work in some other occupation, you would be
entitled to “total disability” benefits.
With the addition or inclusion of
“residual disability” (also called “partial” or “proportionate”)
disability, you have a comprehensive policy that should be purchased by most
executives or business owners, many “white collar” and some “gray collar”
workers and all “professionals.”
The second of the two general philosophies of disability
policies are called ‘Loss of Earnings” policies and they focus not on the
occupation of the insured but whether you have a loss of income due to a
disability caused by an accident or sickness.
If you are disabled due to an accident or sickness and suffer at least a
20% loss of income you are paid a benefit.
These policies are generally marketed to business owners, “white collar”
and some “gray collar workers (and professionals who use their hands or work
with manufacturing machinery). Many of the same types of policy “options” are
available to both philosophies.
When you are “totally” or “residually” disabled and are eligible for disability
benefits, a phone call to the company will trigger the disability claim package
to you. You read the short instructions
and begin completing the application for disability claim.
This unfortunately, is when the general
public begins their nightmare of details that can be very “sensitive” to
whether they are paid or not paid. This
entire “claim process” is foreign to most of us.
The assumption is, the disabled insured truly understands what is
being asked of them by simply reading the claim forms.
Even more important in many claim
situations, is knowing what coverage you have, how and when is it paid, what
additional claim information, medical information and financial information is
needed to begin and then conclude a decision to pay you.
How and when might video surveillance be
used to investigate your claim? Will
the company send you for an “independent medical examination.”?
What other “tools” does the company use to
measure your disability and/or your loss of income?
This process is full of “land-mines” and the
claimant is about to step into on first one if he or she goes it alone.
Before filing for disability insurance
benefits, seek professional help through an independent claims consultant who
can help you through the maze of details, and more!
Visit my web site www.disabilityconcepts.com
Legal Disclaimer
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