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How today’s disabled physicians can effectively protect their benefits.   In Part I of this series, you learned work-related and other health conditions that impair physicians’ abilities to practice. In Part II, you learned what to expect from an insurer when confronted with a disability claim. Now, in Part III, you will learn how to protect your benefits when your company is confronted with your disability claim. The most important factor to understand about the entire claims process is that your disability insurance policy is a contract. It is crucial to appreciate the important and pertinent provisions of your policy […]

The Insurers Strike Back: What to expect from your Disability Insurer when filing a claim. In Part 1, we explored how aging physicians today may experience work-related and other health problems impairing their abilities to practice their specialties or to continue practicing at all. In Part II, you’ll learn what to expect from your insurer when confronted with a disability insurance claim. Changes in the dynamics of the disability insurance industry over the last 10 or 15 years have caused your disability insurance company to become financially driven. The reality is that “it’s all about the money.” When the disability […]

Part I: Identifying Work-Related Conditions As a young attorney in the late1970s, I learned that surgeons and other physicians, often “retired” around the age of 60. In those days, doctors simply left their practices and went on with the rest of their lives, with their most effective and proficient years behind them. But, I always asked myself, why would surgeons at that considerably young age leave such a profound profession, something to which they devoted their entire professional lives? I have come to understand that “retirement” may not be what it’s really cracked up to be — because the physician […]

Background As a law firm dedicated to assisting and representing physicians and health care professionals with disability insurance claims and cases, we have seen, first hand, the disability insurance companies’ response to their “bad block of business” resulting from sales of excellent policies to the physician target market. During the 80’s and early 90’s, the “heyday” of the disability insurance business, physicians were the most highly sought-after market by the disability insurance companies. Benefit periods were extended, contract language was liberalized, and additional benefits, such as residual benefits and COLA, were added in vying for market share. Unfortunately, as physician […]

If you thought Halloween was “scary”, then you haven’t been through the claims process with a disability insurance company. The Companies maintain an arsenal of well-paid, well-trained professionals and claims staff who sometimes seem like they are masquerading at a holiday costume ball. The reality is that the claims process may very well become the consummate “trick or treat” experience. Your goal in filing your claim is to obtain your disability insurance benefits, and as quickly as possible, during a period in your life when you are disabled, most vulnerable, and in financial need. Although this process will never be […]

Spring approaches, one thing that is as certain as “April showers bring May flowers” and kids playing in the park, for you, the disabled physician, claiming benefits under your group long term disability policy is the same as “hope springs eternal”. Almost every disabled physician looking to his or her group policy as part of a financial safety net to maintain your hard-earned quality of life will unfortunately be in for a rude awakening trying to maintain their claim, or even get paid in the first place. Instead, often-times the reality of successfully bringing a claim under your group LTD […]

Do you know your “own occupation”? Chances are you don’t! Sounds like a rather simple and straight forward question. But, when you bring a claim for benefits under your disability insurance policies, your company will redefine the “kiss” rule to be the “kicc” rule: keep it complicated and confusing. “Own Occupation” policies were, and still are, the “Cadillac” policies (or “Mercedes” depending of your auto preference). They are the “creme de la creme”; and when it comes to individual disability income policies, they are the policies held by most physicians. The term is so basic to these policies that the […]

Louis E. Baxter, Sr., M.D, F.A.S.A.M. Mark F. Seltzer, J.D. The impaired health care professional has become the focal point of many recent legal proceedings. The problem of practitioner impairment was resurrected in 1999 when the National Institute of Medicine published a report entitled Medical Errors. The report stated that each year nearly 100,000 patient deaths were a result of mistakes made by medical personnel. The question of health care professional impairment was raised. Accordingly, it is important that these health care providers are identified and whenever possible treated. With the advent of the Joint Commission on Accreditation of Health […]

Editors Note: This is Part II in a two-part series. Read Disability Insurance Claims: Protecting Your Asset (Part I) Welcome back from, what was hopefully, a nice summer vacation and a long intermission from Part I of my Article published in the July/August edition of FYI by the Pennsylvania Chiropractic Association. Let’s get back to reality. . . Now that you understand some of the history and background that preceded your current need for your disability insurance benefits, and the fact that these policies are unique contracts that must be satisfied every month, while you are on claim, in order […]

Editors Note: This is Part I in a two-part series. As a chiropractor, engaged in the active practice of chiropractic, you are customarily used to routinely dealing with insurance carriers considering payment of your bills for professional services rendered. However, what you probably haven’t been exposed to is trying to get paid by your disability insurance company. The latter, is not only a totally different situation, but it comes at a time when you are most vulnerable and most in need of these insurance proceeds. While your years of training and developing your expertise in chiropractic have taught you how […]