Glossary of Disability Insurance Terms
In order to know what you are doing when policy shopping, you must first have an understanding of the basic disability insurance terms. Although this is only a partial list, it should help you. Contact us with any additional questions about other terms.
Attending Physician Statement (APS): The APS is a doctor’s written report about the insured person’s history of health. This report is need for a provider to accurately review your situation and determine coverage and premiums.
Benefit Period: This is the maximum amount of time that you will collect benefits while disabled; the length is determined when picking a policy.
Commencement Date: The first day that a benefits are paid out, immediately following the end of the waiting period.
Continuous Disability: When recurring periods of disability leave caused by the same injury or accident occur within a 12 months of recovery.
Covered Expenses: A list of expenses that are covered or reimbursable by insurance.
Education, Training, and Experience: These facets determine whether someone qualifies for “any occupation” benefits. State laws require insurance providers to take these into account when determining if the insured can return to work at a level comparable to their current occupation. The two criteria considered are:
- Comparable earnings: The alternate occupation should pay similarly to the former.
- Age limitations: for insured over age 55, they must be able to physically and mentally perform the new task, based on local market reviews.
Elimination Period: The amount of time after getting disabled that you must wait before receiving benefits. Also known as the Waiting Period.
Exclusions: Most policies exclude certain factors, such as disabilities from suicide attempts, wart, rioting, or committing a felony.
Guaranteed Renewable: An individual policy that is “Guaranteed Renewable” may not be cancelled as long as the premiums are promptly paid.
Injury: Accidental bodily harm sustained while a policy is in force.
Insurance Company Ratings: There are five major insurance industry rating services, A.M. Best, Standard and Poor’s, Moody’s, Duff and Phelps, and Weiss, which rate the performances of top companies.
Issue Age: The age at which you signed up for your insurance policy. This locks in premiums that may not be changed unless a payment is missed.
Long Term Disability Insurance: When you are injured for an extended period of time, long term plans cover your expenses and helps meet your financial obligations, while also offering monthly benefits and incentives to return to work and get rehabilitated.
Lump Sum Payment: Some policie pay the disablility payment out as one lump sum, rather than monthly installments.
Medical Examination: In order to qualify for coverage, you must first undergo a medical examination to determine your health.
Monthly Benefit: The amount an individual receives monthly while disabled after elimination period is satisfied. It is based off of a percentage of the person’s income.
Net Worth: Used to determine the benefit amount, it is the sum total of a person’s non-business assets.
Non-cancellable: A policy that is non-cancellable may not be cancelled by the insurer as long as premium due dates are met.
Occupation: Inherent risk involved in an occupation help determine the premium and some may not qualify for D.I.
Own-Occupation: Disability insurance of this type allows you to work in another capacity while disabled and not lose benefits.
Portable/Portability: Ability to keep benefits while changing employers
Pre-existing Conditions: Any mental or physical conditions before signing a policy for which the insured has consulted a physician on, received medical treatment, has been prescribed drugs for, or should have sought treatment for within a year before the policy’s effective date. Most policies exclude or reduce benefits for pre-existing conditions.
Premium: This is the monthly amount you pay to maintain your D.I. Failure to make a payment may cancel the policy or allow it to be changed.
Premium Mode: The insured can choose to pay premiums on an annual, semi-annual, quarterly, or monthly basis.
Recurrent Disability: If a disabled person returns to works and becomes reinjured from the same injury or a related injury, then the insured is still considered disabled and will not have another waiting/elimination period.
Rehabilitation: Program designed to speed up recovery of disabled peoples. Some policies include benefits for attending rehabilitation.
Rider: Optional agreements that expand coverage. See specifics below.
Short Term Disability Insurance: These policies typically last between 6 months to a year, with benefits during the waiting period of a LTD plan; often only available through employers.
Smoker Rating: Policy applicants who use tobacco products typically have higher premium rates due to increased health concerns.
Total Disability: This definition determines what benefits a person receives, based off of being able to work in another capacity or being entirely unable to perform duties of any sort.
Underwriter: The insurance company and employee who agree to a contract and receive premiums.
Waiting Period: The total time after getting injured or becoming ill that you must wait before receiving benefits. Also known as the Elimination Period.
Worker’s Compensation: State-run program that provides benefits to employees who are injured on the job.
Common Policy Riders
Riders are additional features you are able to get to incorporate with your policies that increase benefits in certain situations. Listed here are a few of the additional riders we feature:
Hospital Confinement Indemnity Benefits Rider
This particular rider compensates up to $500 for every day you’re hospitalized as a result of an accident. The benefits double for time spent in confinement in intensive care.
Accident Medical Expense Rider
You choose a maximum amount for your policy ($1,000, $2,000, $3,000, or $5,000) and Got DI give you the sum as a cash payment for medical-related bills accrued following a personal injury.
Cost-of-Living Adjustment Rider
Because the cost of living is continually increasing with inflation, we provide this rider for your individual long-term disability rates to increase your benefits while you are impaired, which takes into account the change in real value of money.
Critical Illness Benefits Rider
Some diseases are so severe that we offer the Critical Illness Benefits Rider, which pays out up to $25,000 if you become diagnosed with one.
Future Insurability Option Rider
If you work hard, you will be compensated with raises. This rider increases your base benefits as your salary goes up, no matter your health, allowing for more versatility in the policy. It is only available with an individual long-term protection plan.
Return of Premium Benefit Rider
Depending on your policy, you can have 50 to 80% of your premiums returned (minus claims) after ten years paying the costs. This is available on short and long term policies.
SIS Benefits Rider
Social Insurance Supplement (SIS) Benefits are available only for long term plans and pays additional monthly benefits to claimants if they don’t qualify for social insurance, like Worker’s Compensation or Social Security.