Millions of people are insured by group long term disability plans. However, there are drawbacks to this coverage and situations where the policies will not pay. Unfortunately, many group plans do not pay for the type of disability that is most likely to occur. Theoretically, you are covered. But are you?
Let's contrast some of the more important contract provisions in a group LTD plan and an individual policy. You can come to your own conclusion.
Can the Coverage Be Cancelled?
Group LTD plans can be cancelled in two ways. First, the insurance company can cancel the plan if their claim experience is bad. Second, your employer could decide to terminate the plan at any time. If a company can downsize, it certainly can curtail benefits.
When you buy an individual disability insurance policy, the insurance company can never cancel the policy. You alone decide when you want to coverage to stop.
Can Premiums Be Increased?
If the insurer sees an increase in claims, it will raise the premium on a group LTD plan. Individual policy premiums are frozen for the duration.
What if you change employers? You cannot take your group plan with you. By contrast, your individual disability income plan is completely portable since it is not tied to any company employer.
Today, the average person will change jobs 7 times during their career. There is no assurance that each employer will offer a long term disability plan.
Group long term disability benefits are taxable just like income. Individual policy benefits are 100% tax-free.
Group LTD benefits are reduced by the amount of benefits received from Social Security, Workers Compensation, state cash sickness program, etc. Individual policies have no offsets.
Individual policies have the ability to protect the individual in his or her "own occupation." Typical wording for the definition of disability for group LTD, as it pertains to occupation, goes something like this: "For the first two years, the inability to perform each and every duty of your occupation; after two years, the inability to engage in any gainful occupation."
This means you are covered in your occupation for two years. After that, if you can sell pencils on the street, the insurance company will not pay.
Certain occupations can be covered forever by individual policies. For example, if a urologist becomes disabled to the extent he or she cannot practice the specialty of urology, but could teach urology at a medical school, the individual policy would continue to pay the disability benefits. Moreover, the doctor would receive both the individual policy disability benefits and the medical school teaching salary.
Disabilities that are "presumptive" are those where the insurance company will pay the full benefit even if the person is fully employed. Examples are the loss of use of two limbs, loss of sight, hearing or speech. A person who is in a wheel chair because they lost the use of their legs in a car accident is a typical example. This is a benefit provided by individual policies, but not by group LTD plans.
This is the most important distinction because over 70% of the claims filed at insurance company home offices are for partial disability. The person is not completely unable to work. Their disability may only allow them to work a certain number of hours per day and their salary is adjusted downward accordingly.
An individual plan pays a percentage of the total benefit that represents the percentage of income lost. For example, if a person making 5,000 a month with a 3,000 a month individual policy benefit loses 60% of their income due to a disability, the policy would pay 60% of 3,000 or 1,800. Most group plans do not pay for a partial disability.
You have seen that group long term disability income plans can be cancelled, premiums waived and lack portability. Benefits are taxable and are offset by other plans. They posses no ability to protect an occupation and, most important, most do not pay for the type of claim most likely to occur: partial disability.
Individual disability insurance plans do not have these limitations. They cost more, but when it comes to disability coverage, you get what you pay for. If you get in an accident or develop a sickness that inhibits your ability to put food on the table, your thoughts are not focused on what the premium is for your disability income insurance coverage. You simply want to know when your disability check will arrive in the mail.
Robert D. Cavanaugh, CLU is a 36-year financial and estate planning veteran and author of the free newsletter, "The Estate Preservation Advisor". For cutting-edge, easy-to-understand financial planning resources and techniques to increase your income, reduce taxes and preserve your estate and to claim the free video, "How to Sell Your Life Insurance Policy for More than the Cash Value", go to http://theestatepreservationadvisor.com/rd/subscribe.htm