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PRACTICE MANAGEMENT 

Introduction to Disability Insurance: Why is it so important for an Ob/Gyn?

By Ray Bourhis and Kathleen DeFever | November 15, 2012

Disability insurance is an important part of a well-rounded financial plan. Of course, no one can predict if you will become disabled during your years as an ob/gyn, but if you do, this insurance can mean the difference between maintaining your lifestyle and losing everything you have worked for.

Different Types of Coverage
Disability insurance policies are not all created equal. To ensure you purchase the coverage that best fits your specific needs as an ob/gyn, it is crucial that you understand the important points of a policy and know which questions to ask the broker. For example, you can opt for coverage to Age 65 or Lifetime; for physical ailments and/or mental; for when you are unable to perform your own occupation as an ob/gyn or for the event that you cannot perform any occupation; etc. The combinations are endless and complex, but with some careful planning, you can ensure you are purchasing a valuable policy.

Own Occupation vs. Any Occupation
As an ob/gyn, you should purchase a policy that specifically covers you for your OWN occupation. There are two steps to ensure you are covered for your own occupation, as opposed to any occupation:

1) Be very specific with the broker that you wish to be covered as an ob/gyn, and not as a general doctor or just as a person in the workforce. Your broker will provide you either with a policy that is automatically an Own Occupation policy (and do ask to see the language), or he/she will attach a rider to the policy that indicates you are covered for your Own Occupation.  The rider will control any conflicts with the policy language. Review the policy and the rider to carefully to be certain there is no automatic conversion clause that will change your coverage from Own Occupation to Any Occupation after you are receiving your benefits.

2) When you fill out the policy application, indicate your profession and be specific. If you are a general ob/gyn, indicate this.If you have a specialty in the ob/gyn field (e.g. Gyn/Oncology Surgeon), indicate it.  Ask to be covered for that specialty and indicate the specialty on the application form. If you are not covered for your specific work, when you become unable to practice your specific occupation you will still be unable to receive your full disability benefits unless you are unable to perform ANY occupation. The way this is interpreted can vary widely, but it will certainly result in a decrease in paid benefits.

Knowing Your Rights
Besides knowing which questions to ask your insurance broker, it is also important to understand how your policy will be handled in the event you need to make a claim. For this, you should do some research on the reputations of the insurers you are considering, and find out how the law will protect you in the event of a coverage dispute. Most crucially, you should avoid your policy being subject to ERISA. ERISA is a federal law which controls the standards your insurer must meet when it considers your claim, and it affords the insurer a very wide margin of error.

Understanding Claims - Both Yours and Your Patients'
A general understanding of disability insurance is important not only because, as a medical professional, you may wish to purchase a policy. Your understanding is also important for your ob/gyn patients. When a claim is filed for disability insurance benefits, the claimant must submit an attending physician's statement. If the attending physician is not careful when completing this form, or has a poor understanding of what constitutes a disability under an individual disability insurance policy, he/she can inadvertently cause a truly disabled patient to lose his/her disability benefits.


 

Our disability insurance blog for ObGyn.net is aimed at assisting you with your questions about disability insurance, in an easy to read blog-style format.  The blogs are not meant as legal advice, but as a general aid in your understanding of disability insurance coverage.

Ray Bourhis Associates
1050 Battery Street
San Francisco, CA 94111
415.392.4660
Ray Bourhis
Kathleen DeFever
http://raybourhis.com
http://insulttoinjury.org
info@raybourhis.com

 

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