Bonny Rafel was invited by the president of the New Jersey Dental Association to present a lecture on disability insurance for the dentist at the recent annual conference in Atlantic City, NJ, June 4, 2009. She presented an overview of the types of insurance, including business overhead insurance, which provides for the payment of your expenses while disabled, buy out insurance, which insures for the potential that you may become disabled and your dental practice may have to buy out your ownership interest in the business, and individual disability insurance providing income benefits should you become unable to perform the material duties of your occupation. She warned against a common tactic by insurance companies to seek out a “dual occupation” scenario.
Dual occupations in the disability context most often arise when the insurer claims its policyholder is not disabled since he can still perform important aspects of his other occupation. The insurer argues that the insured had two or more occupations at the time the insured claims to be disabled, and because the insured remains able to work full time in one of those occupations, the claimant is not entitled to benefits. This is often a fabrication of fancy wordsmithing the occupational duties of a single occupation into another.
An insurance company may claim the dentist or doctor really had two occupations, one working as a surgeon or dentist, and another, keeping office hours, and running his medical practice.
Here, the submission of detailed records and an overview of the duties of the occupation which cannot be performed is key to a successful claim. However, she cautioned that often the insurance company sends authorizations for the unwary claimant to sign which then entitles the company to investigate his entire financial status, including obtaining credit card records, personal investment details and other data that is not relevant to the claim and invasive of the claimant’s privacy.
“As long as the information is relevant to the claim, you should provide it, but when it crosses the threshold into private matters,” she suggested, “do not provide this data because once in the insurance company’s file, it is no longer protected under HIPPA or from disclosure to the public.”
She offered her services to dentists in attendance, who then sent their disability policies for her to review to examine the level of income protection the dentist has purchased and whether this “investment” is “likely to pay off” should disability strike.