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DISABILITY INSURANCE
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Of all of the things for which we buy personal insurance coverage,
disability is the most likely to occur. Disabilities are, at
best, traumatic. Physical stress can be trying enough without
concerns about paying financial obligations. Disability insurance
is available in many forms, and due to the nature of the risk,
which may be partial or total, policies can appear to be complicated.
Essentially three basic types of disability contracts are available:
- Group Long Term Disability. Neither the
premium nor the definitions are guaranteed. The insurer can,
generally each year on the renewal date, change the coverage
which you have, and / or change the premiums which you pay, or
cancel the policy.
Definitions in Group Long Term Disability contracts are almost
always designed in such a way that the risk to the insurer is
reduced by any other insurance which you have, and by any benefits
from the government (including CPP disability benefits), from
car insurers, or by any income which you can earn.
Group insurers also maintain the right to insist that you participate
in a mandatory rehabilitation plan, of their choosing. If you
don't participate, the claim is cancelled. If you do participate,
the claim is reduced. This allows them to reduce their risk of
payment.
- Guaranteed Non-Cancellable Individual
Disability Income Protection. Policies are fully guaranteed.
They can not be cancelled by the insurer. The insurer can't change
the premium which you pay. The insurer can't change the contract's
definitions. Only you can make changes to the policy. This is
the only form of coverage where the insurer accepts the full
risk.
- Guaranteed Renewable Individual Disability
Income Protection. The insurer guarantees to renew the policy,
with the existing definitions, at whatever premium they feel
that they require to meet their obligations. This type of coverage
transfers much of the risk to you. The insurer knows that all
that they have to do is to charge a very high premium to get
you to cancel your policy.
QUESTIONS TO ASK ABOUT DISABILITY INCOME PLANS
- Is the plan (both the coverage and the
premium) cancellable or changeable at the insurer's option?
- Is the plan guaranteed to be renewable
at least to age 65?
- Is the definition of injury restrictive?
Does it have to be independent of all other causes?
- Are cost of living benefits guaranteed?
- Will benefits be paid for partial disability?
- To qualify for partial disability benefits
does an individual first have to be totally disabled for a fixed
period of time?
- Can days required to satisfy the waiting
period be accumulated or do they need to be consecutive?
- Will benefits be paid for residual disability?
- Can full benefits be paid if working in
another occupation while unable to do own occupation?
- Would income billed prior to disability
but collected during disability have a tendency to reduce benefits?
- Are benefits payable for the full duration
of total disability or for a lesser period determined by age?
- Is guaranteed insurability an aspect of
the contract?
- Is guaranteed insurability related to
increases in income?
- Are emotional and psychological disabilities
covered?
- Are self inflicted injuries, while sane
or insane, covered?
- Is own occupation coverage available within
exact areas of specialization?
- Is the own occupation definition permanent,
or only available for the first few years of claims?
- Who mediates your claim? Is it a clerk
employed by the insurer, or your agent?
Guaranteed Non-Cancellable Disability Insurance - Available Coverage
- Each contract is non-cancellable and guaranteed
renewable at least to age 65. The renewal premiums are guaranteed
by the insurer in the contract. Individually owned Disability
Income Protection Policies provide 24 hour, 365 day, world-wide
coverage on a tax-free basis to qualified individuals.
Guaranteed Insurability will protect your increasing earning
power. Increases in benefit amount will be available annually,
in amounts of up to $500 to $2,000 per year, subject to financial
evidence and age (55). One such option would be exercisable during
any period of disability.
- Partial Disability benefits allow for
the accumulation of days of partial disability provided that
such days are separated by no more than 12 months. To satisfy
the elimination period stated in the contract there is no prerequisite
of any total disability.
Residual disability comes into effect once total disability has
ended and you return to work at less than 80% of pre-disability
income.
Both benefits will create pro-rata payments to allow the gradual
increase of post-disability earned income to pre-disability levels.
In both cases pre-disability income will be indexed for inflation
to increase the duration of a claim and offset the effects of
inflation.
Thus the contract will not require that the Elimination Period
be of consecutive days in duration, nor will it require that
days of disability contributing to the elimination period be
days of total disability.
- Monthly earnings prior to an eligible
claim will be based on the most favourable of two income periods.
The definition of sickness in the contract refers to the first
manifestation of symptoms, rather than the commencement date
of eligible disability. This will prevent the reduction of benefits
due to decreased earnings during periods of progressive disability,
leaves of absence, special assignments, or other special circumstances.
- There are no sources of income by which
the insurer of an individual disability income contract may offset
an eligible claim (except earnings in your own occupation).
- There is no requirement for you to participate
in a rehabilitation programme if you are disabled. If disabled,
you may request that the insurer fund the costs associated with
a rehabilitation programme of his choice. Provision for the payment
of rehabilitation expenses are a part of the disability contract.
- You qualify for disability income benefits
based upon total accrued earnings. These amounts are generally
available without limitation, and based solely on prior income.
- A cost of living adjustment is available
at 5% or 8 % (based upon the C.P.I.), per annum during a period
of disability. These amounts are not be subject to a maximum
dollar limit.
- After you have returned to work, the policy
allows for the continuation of the increased coverage obtained
as the result of inflation indexing. There are no exclusions
in the application of this benefit. Thus in spite of inflation,
the coverage available to you when you return to work following
a period of disability will be sufficient to meet your continuing
needs.
- Individual contracts are "full indemnity
contracts" and will only be reduced by the percentage of
prior income earned while partially or residually disabled.
- Residual disability benefits will be indexed
as an aspect of the basic individual disability income contract.
This applies equally during periods of rehabilitation.
- The individual disability income contract
does not require that the Elimination Period be of consecutive
days.
- A lifetime benefit option is available
which would allow for the continuation of benefits past your
65th birthday. This will provide a disability retirement supplement.
- After the contract has been in force for
at least two years self inflicted injuries, while sane or insane,
are covered.
- Successive periods of partial, total,
or residual disability, or any combination thereof, which are
separated by fewer than 12 months of active full time employment
will be considered as one uninterrupted period of disability.
- Loss of sight, hearing, the use of any
two limbs, or the ability to articulate clearly will be considered
as total disability, regardless of income earned subsequently.
This will allow a disabled individual to develop a new earnings
strategy. This benefit would continue to be paid to age 65, or
for life by rider.
In addition to the base contract of disability income protection,
many individuals have taken advantage of the following forms
of protection.
RETIREMENT ACCOUNT PROTECTION
Retirement Account Coverage will create a self-administered trust
fund. Deposits of up to $2,000 per month (depending upon the
amounts purchased) will be made for each month which you are
disabled, following a 90 day elimination period. Principal deposits
are tax free and the interest earned in this account would be
taxable. The fund should allows for the withdrawal of up to 54%
of the interest earned annually to pay taxes.
This would result in the accumulated fund at age 65 being tax
free. In the event of a death prior to age 65 the accumulated
value of the fund would be released to a named beneficiary.
For periods of disability, this will result in your continued
ability to accumulate for retirement. This can occur without
encroaching upon regular monthly disability income payments or
upon other sources of income.
BUSINESS OVERHEAD EXPENSE DISABILITY PROTECTION
- Each contract is non-cancellable and guaranteed
renewable at least to age 65. The renewal premiums is guaranteed
in the contract. Individually owned Disability Income Protection
Policies provide 24 hour, 365 day, world-wide coverage on a tax-free
basis to qualified individuals or businesses.
Guaranteed Future Insurability will protect your increasing expenses.
Increases in benefit amount should be available annually, in
amounts of up to $500 to $1,500 per year, subject to financial
evidence and age (55). One such option may be exercised during
any period of disability.
- Partial Disability benefits allow for
the accumulation of days of partial disability provided that
such days are separated by no more than 12 months. To satisfy
the 30 - 180 day elimination period stated in the contract there
is be no prerequisite of any total disability.
Residual disability comes into effect once total disability has
ended and for as long as the business continues in a deficit
position.
Thus the contract does not require that the Elimination Period
be of consecutive days in duration, nor does it require that
days of disability contributing to the elimination period be
days of total disability.
- The definition of sickness in the contract
refers to the first manifestation of symptoms, rather than the
commencement date of eligible disability. This will prevent the
reduction of benefits due to decreased earnings during periods
of progressive disability, leaves of absence, special assignments,
or other special circumstances.
- There is no requirement for you to participate
in a rehabilitation programme if you are disabled.
- The contract does not require that the
Elimination Period be of consecutive days. It does not require
that days of disability contributing to the elimination period
be days of total disability.
- After the contract has been in force for
at least two years self inflicted injuries, while sane or insane,
will be covered.
- Successive periods of partial, total,
or residual disability, or any combination thereof, which are
separated by fewer than 12 months of active full time employment
will be considered as one uninterrupted period of disability.
Disability Income Protection
- Waiting Periods:
30, 60, 90, 180, 365, 730 days of Total or Partial Disability
(these may generally be accumulated in consecutive or non-consecutive
days of disability within a fixed period);
- Benefit Payment Method:
monthly payments pro-rata to loss of (inflation indexed) income
- Benefit Payment Duration:
24 months, 60 months, to age 65, to age 71 and for life (depending
on insurer).
Business Overhead Expense Disability Insurance
- Waiting Periods:
30, 60, 90, 180 days of Total or Partial Disability (these may
generally be accumulated in consecutive or non-consecutive days
of disability within a fixed period);
- Benefit Payment Method:
monthly payments pro-rata to loss of income (may be tied to individual's
or Corporation's loss)
- Benefit Payment Duration:
12, 15, 24 or 60 months (depending on insurer).
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