Disability insurance for dentists

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PostPosted: Tue Aug 24, 2010 7:33 am   Post subject: Disability insurance for dentists  

I'm a student of medicine from CO. I'm aware of dental insurance, but I recently attended a seminar where they stressed upon the necessity of a disability insurance policy. Do all dental surgeons need disability insurance?


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Dr.Jonesmurpley
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PostPosted: Tue Aug 24, 2010 1:18 pm   Post subject:   

The only dental surgeons who need disability insurance are those who are working because they need income.


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sdkfjar
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PostPosted: Wed Aug 25, 2010 5:49 am   Post subject:   

I guess it's now a necessity with all dental specialty. I guess one needs to stay covered (for total disability) either for lifetime or up to 65 years age. Perhaps, that's what we mean by their definition of own-occupation.

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PostPosted: Wed Aug 25, 2010 1:09 pm   Post subject:   

I dont think there will be a specific disability insurance targeting dentists. i think if they do want a disability insurance then a normal one which is applicable to all will suffice.

Since i dont think dentist's profession includes any risk which may lead to disability of any type.



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PostPosted: Thu Aug 26, 2010 5:33 am   Post subject:   

Being a dentist you'd need to fulfill certain duties both substantial and material. So, if you're gonna apply for disability insurance you'd need to make sure that your policy covers your specialty.



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PostPosted: Thu Aug 26, 2010 12:10 pm   Post subject:   

Is it ? is there some risk involved in this profession?



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PostPosted: Fri Aug 27, 2010 4:41 am   Post subject:   

For any person with specialized occupational skills, or anyone who is self-employed, the proper type of disability income insurance policy is one with an OWN OCCUPATION definition of total disability.



The best policies in this category will not change the definition of disability to ANY OCCUPATION after a certain period of time.



Most policies will run (or start) a disability claim up to age 65, but a few offer "lifetime" coverage. The more coverage one wants, the more it will cost.



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PostPosted: Fri Aug 27, 2010 5:43 am   Post subject:   

Hey Max..jus one question...is it just the difference of premiums for the ones that stretch for life time? Or do they also differ in terms of features?


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PostPosted: Fri Aug 27, 2010 10:20 am   Post subject:   

Lifetime coverage is very rare. It's not available with all occupations. I don't know of any companies that offer true lifetime coverage anymore. It's all limited to some extent.



The general rule with disability coverage is that you get what you pay for. If one policy is $3,000 and another is $1500, you can bet that there is a reason for the price difference.



When one buys coverage through work, it is very cheap. Don't be fooled and think that it is because of a group discount. It is because the contractual language won't be good.


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fjakreka
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PostPosted: Sat Aug 28, 2010 9:35 am   Post subject:   

I do understand the problem with these contractual languages. But I'm really wondering as to what occupations will avail such life time coverages!


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PostPosted: Sun Aug 29, 2010 3:13 pm   Post subject:   

It's not the occupation but the insurance company. Few, if any, are offering lifetime coverage these days.



The cost for such coverage is not cheap, and the only ones who could truly afford it are persons with very high incomes . . . physicians, surgeons, dentists, engineers, accountants, lawyers . . . are the ones who come to mind first, and the ones who might be most interested. It is not a "blue collar" item.



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When one buys coverage through work, it is very cheap. Don't be fooled and think that it is because of a group discount. It is because the contractual language won't be good.




This statement may or may not be correct. Many employer-sponsored disability income policies are both contractually very good, and low cost (if the employer subsidizes or pays the full cost of the insurance) -- at the agency I formerly worked in, our group LTD policies from Unum-Provident had premiums in the $1.75-$2.00 per $100 of benefit, up to $12,000 per month (60% of pretax income limit) -- so for an executive who would receive the maximum monthly benefit, the cost was only $240 per month, paid 100% by the employer (making the benefit 100% taxable to the employee, if the premium is not imputed as income). The benefit was only payable to age 65.



"Supplemental benefits", usually paid solely by the employee, are a different matter -- and the phrase, "You get what you pay for" is appropos.


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PostPosted: Mon Aug 30, 2010 2:02 pm   Post subject:   

Max, employer sponsored plans can be advantageous. Many of these are sex distinct and have discounts. This can be a huge money saver, especially for females. What the good ones have in common, though, is that they are individual coverage and not group coverage.



One huge disadvantage with group coverages is that they are covered under ERISA. This makes it much easier for insurance companies to deny claims with greater impunity.


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PostPosted: Mon Aug 30, 2010 3:48 pm   Post subject:   

Quote:
Max, employer sponsored plans can be advantageous.




I'm sorry. Did you see anything in my posts to the contrary?



Many supplemental benefit plans are made available to employees by payroll deduction, but are not employer-sponsored plans. They are often low cost, and sometimes provide only limited benefits. The company with the quacking duck in its commercials should come to mind. Limited benefits does not mean lousy coverage, it simply means you have to know what is and is not covered. Some "disability income benefits" are only paid if, and only for as long as, a person is hospitalized. And even then, perhaps only if due to an accident.



Quote:
One huge disadvantage with group coverages is that they are covered under ERISA. This makes it much easier for insurance companies to deny claims with greater impunity.




How can you make this statement? ERISA does not govern the provision of benefits themselves, state laws do, although ERISA does mandate that certain things be INCLUDED, such as maternity benefits, that are less likely to be found in an individual health insurance plan these days. ERISA preempts state laws that are in conflict with it, such as allowing an insured the right to sue an HMO in certain circumstances, or a law that allows maternity benefits to be excluded. But nowhere in ERISA does it state that insurance companies may deny claims in group insurance contracts with impugnity. The contract is the contract.



For example, ERISA has not been held to disallow states from setting up independent medical review boards in cases where an HMO patient's physician recommended a procedure, the HMO's internal review physician also recommended the same procedure, and the HMO still denied the procedure anyway. When the HMO denied it again after the state's independent review board recommended the procedure for the patient, and the patient paid for the $100,000 life-saving procedure on her own, she then sued the HMO, which claimed immunity under ERISA. The case went all the way to the US Supreme Court, and the insurance company was properly spanked by the high court. You can look up the case on the SCOTUS website. The decision involved an insurance company in the state of Illinois about 6-7 years ago. It cost the insurance company a far larger amount of money to deny that $100,000 surgical procedure.



ERISA intends to prevent discrimination in providing benefits to plan participants and plan beneficiaries within the same occupational class. It also describes "vesting schedules" and other eligibility requirements for group benefit plans offered/sponsored by employers with 20 or more full-time (or full-time equivalent) employees.



ERISA says nothing about an insurance company's right to deny claims when coverage is stated in a contract, and no insurance company has the right to deny claims with impugnity.



Just ask Unum, the company I mentioned above. They have first-hand knowledge of what can happen when an insurance company violates the language of the group and individual disability income contracts it issues. They paid millions of dollars in regulatory/administrative fines to almost every state in the US as the result of their misinterpretation of their own contracts' language, which led to claims denials and unfair claim practices charges.



There is no peculiar advantage or disadvantage to any group insurance policy under ERISA. And group insurance policies do not normally have less beneficial contract terms than individual policies. But some individual policies can be written with more favorable terms, and significantly higher premiums than group policies, simply because the employer is not willing to pay for the sun, moon, and stars.



And while ERISA provides for continuation of group health insurance (courtesy of COBRA 1985), it says nothing about continuation of group life or disability insurance. It does promise convertibility of group coverage to an individual plan of insurance without proof of insurability within 31 days of termination of eligibility for the group insurance.



If you have something specific to refer to, please do. Otherwise, don't make broad assertions that are untrue.


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PostPosted: Mon Aug 30, 2010 7:35 pm   Post subject:   

Max, Either you are unaware or spend too much time in the classroom. The issue with ERISA has nothing to do with benefits. It is an issue of claims. The claim’s process is spelled out and a claim will only be overturned if the denial is “arbitrary and capricious”. There are no consequential or punitive damages that the insured can collect. The best case scenario is that the claim will get paid and it is possible, but rare, for attorney fees to be rewarded.

Contrast this with non-Erisa policies. The burden of proof is identical to a civil trial. All that is needed is a preponderance of evidence and one can get punitive damages.

My opinion is that the Unum case would never have happened if the policies were not governed by ERISA. They would have had thousands of individuals successfully suing them and collecting damages. It’s not coincidental that most issues with difficulty in the clam’s process are with ERISA policies.

Max, let’s be serious here. If your disability claim was denied, would you rather it be an ERISA policy or a non-ERISA policy? The answer is cut and dry.


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fjakreka
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PostPosted: Tue Aug 31, 2010 10:20 am   Post subject:   

Quote:
The claim’s process is spelled out and a claim will only be overturned if the denial is “arbitrary and capricious”.


Can you show me through some examples?

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