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Ben Glass
Ben Glass
Attorney • (703) 584-7277

Disability Insurance Provisions to Avoid

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Some disability insurance policies provided by employers aren’t worth the paper they are printed on. People are often shocked to find that even though their doctors fully support their disability and, in some cases, they have been awarded disability benefits by the Social Security Administration, their employer’s plans are so bad that the insurance company does not have to pay benefits.

The vast majority of these bad policies represent employers who simply have been duped by the insurance companies. Our experience is that employers and human resource personnel often have no real idea of how bad their own disability program is.

The law does not require an employer to provide long term disability coverage, nor does it mandate the terms of any coverage that is provided. Basically, there is no federal or state oversight over policies insurance companies can offer through employers. While states can and do regulate the terms of so called “private” policies that are offered to individuals there is no corresponding oversight of employer-sponsored policies.

Check your disability insurance policy right now. If you see any of the following language in your policy, either run and scream to your human resources department or run and go find a private policy–your policy is not protecting you the way you might think it should:

Language granting the insurance company discretion to determine benefits
* A definition of disability that requires that you not be able to perform “each and every” important function of your job before being paid benefits
* An “own occupation” period of less than two years
* Income protection of less than 60% of prior earnings
* Language terminating all benefits if you are “able to work part time but don’t”
* Blatant discrimination against the mentally ill
* Limitations on disabilities caused by so-called “self reported symptoms”
* Benefits which are contingent on securing social security disability benefits
* A limitation on benefits for Fibromyalgia or chronic fatigue

No prudent purchaser of insurance, when they really understand what they are buying, would buy a policy containing any of these provisions. Why? Because they are buying “air.” They are buying the illusion of protection.