The old saying goes, “You can’t sell from an empty wagon.” But in the physician group LTD space, emptying the wagon of provisions that can hurt doctors at claim time (included as standard language in many traditional group LTD policies) can be your most powerful tool.
The Right Tool for the Right Job
Traditional group LTD policies are great products. They work well for their intended audience, which includes the majority of the working public engaged in normal commerce. Most people who work in an office, service or manufacturing setting don’t require special disability provisions and protections.
Physicians, on the other hand, are an entirely different story.
Doctors Are Different – Very Different
Physicians’ requirements for disability coverage are unique. Traditional LTD coverage that fits the majority of other clients not only lacks features docs require, but contains many standard provisions that are detrimental if they go out on claim. The key differences that make physicians’ needs unique include:
- Strong work ethic. As a rule, docs are hard working, highly motivated individuals. They attempt to work around and through illness and disability to a higher degree than the general population. The majority routinely work beyond a 40 hour work week.
- Strong return-to-work motivation. With the time and expense invested in professional training and building a practice, they are highly motivated to keep working in any capacity they can. In fact, doctors are 10 times more likely to return to part-time work in their profession than the general public.
- High degree of specialization. The medical community today officially recognizes over 138 medical specialties and sub-specialties. This degree of specialization requires unique disability provisions to determine what constitutes being disabled from their job. This applies not only to total disability, but also flexible ways in which physicians can return to work in a different capacity.
- Strong medical understanding. Because they are deeply involved as specialists in assessing and treating others, when they are sick or disabled, physicians have a much clearer idea of treatments, limitations and rehabilitation that will be effective for their own recovery, and are resistant to non-medical opinions regarding treatment plans and capacity.
- International scope. More than a quarter of all physicians in the U.S. are categorized as International Medical Graduates (IMG). If disabled, many of these doctors might opt to return to their country of origin. They want the option to leave the country without fear of their disability payment ending.
Brokers who achieve the highest success with physician clients focus on three essential elements:
- Point out provisions that physicians don’t need and don’t want in a contract that are included in traditional group LTD policies but not usually highlighted or discussed in the proposal. This is selling what you don’t have. These provisions are designed to get a physician off claim as quickly as possible.
- Ensure that you offer a policy that is specifically tailored for physicians – excluding the detrimental provisions but also including those that are most important to physicians. Specialized Physician LTD policies are designed to maximize physician income protection.
- Position your offering as an IDI Supplementand focus on key features such as Own Occ/Specialty/sub-specialty in order to highlight the strength of the physician specialty contract.
Standard Group LTD Provisions: Potential Physician ‘Gotchas’
Many physicians buy traditional group LTD coverage unaware of the included standard provisions that can prove highly detrimental to them if they are faced with disability. The stickler is that most carriers don’t highlight or discuss these provisions in a their proposals. The potentially problematic features can include:
- Self-reported limitations — Back pain, carpal-tunnel, fibromyalgia, etc.
Hard to diagnose and quantify, these maladies can affect physician’s ability to perform normal work, but aren’t recognized as a legitimate claim. And according to the AMA, back problems (muscular-skeletal disorders) are the #1 cause of disabilities.
- Mental/nervous illness & substance abuse — 24 month aggregate lifetime max
These conditions are often recurring and require sustained therapy and support.
- Mandatory rehab — Retrain to alternate work
Docs often do better in a ‘down-specialty’ situation than a rehab scenario
- Maximum capacity requirement — Carrier-specified work capacity
Docs understand their physical capacity and recovery better than insurance adjusters and rebel against carriers that stop their disability check because the carrier thinks the doctor should be working more.
- Part-time work requirement — Must perform partial material duties
Physicians may elect to not return part-time to work outside their chosen specialty
- 40 hour work week limit — Many docs work > 40 hrs
Even during recovery this limit may be exceeded
- Recommended treatment requirement — Treatment refusal terminates benefit
Docs may refuse certain treatments for medical reasons based on their knowledge and experience.
- Elective surgery exclusion — Surgery-related disability terminates benefit
Physicians are more inclined to take advantage of surgeries that may enhance their health (e.g. Lasik)
- International travel or living restriction — Must remain in U.S. to receive benefit
As noted above, many doctors have international ties and aspirations.
By avoiding contracts that include these provisions and offering specialized contracts tailored for physicians, many brokers have demonstrated the ability to consistently close extremely high ratios of physician cases at price premiums. See High Percentage Selling for more details.
For producer use only
Group disability insurance policies are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) in all states, except New York under policy form 93P-LH. In New York, group life and disability insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Windsor, CT) under policy form 13-GP-LH-01 and 13-LTD-C-01. Administration for physician products is provided by Medical Group Insurance Services, Inc. (MGIS), in all states, except as follows: in CA by MGIS Insurance Agency, Inc; in NY by MGIS Insurance Agency. Product offerings may not be available in all states and may vary depending on state laws and regulations. Sun Life Financial and the globe symbol are registered trademarks of Sun Life Assurance Company of Canada. Visit us at www.sunlife.com/us.
 Physician Characteristics and Distribution in the US, 2013 Edition, American Medical Association, pg 29