DisabilityPro Insurance Coverage Details
Monthly Benefit Amount Up to $15,000
Physicians under age 55 may apply for up to $15,000 in monthly benefits for total disability. Physicians age 55 to 60 may apply for up to $5,000 in monthly benefits. Benefits are payable regardless of whether your disability is caused by accident, illness, or organ donation. Benefits from this plan when added to any other disability insurance in force or applied for cannot exceed 66 2/3% of your monthly income or $30,000, whichever is less.
Up to a 35% Rate Reduction
All insured physicians receive a 15% rate reduction for at least the first year of coverage. Members of the American Medical Association receive a 35% reduction. These premium credits have lowered the cost of this insurance since 2006.
"Own-Specialty" Disability Definition
Unlike some other disability plans, this plan contains a preferred definition of disability. If you are unable to perform the duties of "your own medical specialty," benefits can be payable up to age 67.
Long-Term Benefit Periods
If you are disabled by accident, illness, or organ donation before age 62, benefits under this plan are payable up to age 67. If you are disabled between the ages of 62 and 63, benefits are payable for up to 60 months. At age 63 and after, the benefit period is reduced by six months depending on your age at disability. From age 70 to 75, benefits are payable up to 12 months.
Benefit Period Limitation
If you are disabled due to mental, nervous or emotional disorders before age 69, benefits under this plan are limited to 24 months. At age 69 and 70, benefits are limited to 18 and 12 months, respectively. (If such disability begins before age 65, benefits are payable up to age 67 if you are confined to a hospital at the end of 2 years and such confinement has been continuous for the immediately preceding 12 months.)
Medical School Loan Payment Benefit — up to $200,000
This benefit is available to physicians insured prior to age 40. This benefit could pay up to $200,000 of eligible student loans if you are totally and permanently disabled before age 45. This benefit is paid in addition to your monthly disability benefit and it's included in your coverage at no additional charge.
Catastrophic Disability Rider
The Catastrophic Disability Rider provides extra benefits for disabling conditions that require extended care. Should you become totally disabled and lose the ability to perform two of the six activities of daily living - bathing, dressing, toileting, transferring, eating, or continence - you can receive this monthly benefit in addition to your base monthly disability benefit. By adding this optional benefit, you will receive a 30% increase (up to $4,500) in your total monthly benefit for only 10% additional premium up to age 60 (or 20% additional premium if age 60 and above). You must have a minimum of $3,000 in base disability benefits to qualify.
Cost of Living Adjustment (COLA) Option
For just 15% additional premium you may add the COLA option. With it, the monthly benefit payable for a covered total disability may be adjusted annually to reflect changes in the cost of living based on the CPI-U.* Years are measured from the start of the waiting period. In the first year, no adjustment will be made. Adjustments may be made to the monthly benefit paid in the second and each succeeding year. Note: If you choose this option in addition to the Catastrophic Disability Rider above, the cost of the COLA option will be an additional 1.5% in premium for a total of 16.5% (or an additional 3% in premium for a total of 18% if age 60 and above).
*"CPI-U" means the Consumer Price Index for All Urban Consumers, All items, as published by the Bureau of Labor Statistics. If the CPI-U, in New York Life's opinion, is no longer a valid index for the purpose of this Option, or is no longer published by the Bureau of Labor Statistics, they will use a new index.
Extra Benefits for Rehabilitation
To help you recover, you may also qualify for rehabilitation benefits in addition to your monthly disability benefit if you participate in an approved accredited occupational rehabilitation program while you are disabled.
Residual Benefits for Part-Time Work
This plan allows you to make a gradual transition back to full-time employment following a covered total disability. You can receive a residual benefit if you return to work on a part-time basis in your own specialty or any other specialty or occupation if your monthly income is reduced by at least 20 percent, and you first receive benefits for total disability. The residual benefit is based on a percentage of your total monthly disability benefit.
Future Benefit Increase Option
If you are under age 40, this option may allow you a future increase in benefits with no health questions or medical exams required if your income increases and you remain actively at work. This one-time option must be exercised within the first three years of your original effective date or before your 40th birthday, whichever comes first.
Communicable Disease Benefit
If you contract a Communicable Disease* before age 67, you may qualify for coverage without the requirement that you suffer a covered total disability. You'll be eligible for this benefit if the illness causes you to earn less than 75% of you average monthly income for the period before your practice was limited and/or condition was disclosed as a result of contracting the disease.
*Communicable Disease means any of the following conditions, but only if: (a) the medical profession recommends; or (b) an appropriate governmental agency requires; the disclosure of the diagnosis of the Communicable Disease and/or a limitation of his or her practice due to contracting the Communicable Disease: Acute Viral Hepatitis of a non A type, Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS) or tuberculosis.
Family Care Benefit
This plan will pay up to one basic monthly benefit to you to care for a close family member with a Serious Health Condition.* Your spouse or domestic partner; child, including a step-child, adopted child or child of your domestic partner; or your parents, are considered "close family members." The health condition must be certified by the family member's licensed attending physician.
You must be working at least 20% fewer hours and have a loss of 20% or more of your average monthly income, due to the time off to qualify. The monthly benefit is the amount payable in proportion to the loss of monthly income up to a maximum of one basic monthly benefit.
0%-19%: No benefit
20%-25%: 25% of the Basic Monthly Benefit is payable
26%-50%: 50% of the Basic Monthly Benefit is payable
51%-75%: 75% of the Basic Monthly Benefit is payable
76%-100%: 100% of the Basic Monthly Benefit is payable
*Serious Health Condition is a condition that causes the family member: to be unable to complete, without substantial supervision, two of six "activities of daily living," including bathing, dressing, toileting, transferring, (e.g., in and out of bed), eating and continence; to require substantial supervision due to severe cognitive impairment; to be hospitalized; or to become terminally ill with a condition that is reasonably expected to result in death within 12 months.
Layoff or Leave of Absence Benefit
Your insurance can continue beyond the end date of the coverage if you cease to be employed full-time due to layoff, leave of absence, or a leave of absence required by state law or by the Family and Medical Leave Act of 1993 (FMLA). Your coverage will continue for up to 90 days during a temporary layoff or a leave of absence other than state mandated leave or FMLA; or the greater of the period required by state law or by FMLA provided the leave authorization is in writing and required premium is paid.
The insurance will then end on the earliest of 90 days after the temporary lay-off or leave of absence (other than state mandated leave of FMLA) began; the date the layoff becomes permanent; the date the state mandated leave or FMLA leave ends; or the date insurance would otherwise end.
Your Choice of Waiting Periods
Select a waiting period of 2, 3, 6, or 12 months. The waiting period is defined as the period of time from the start of total disability during which no benefits are payable. The waiting period is only satisfied if you are not working in any occupation. (Note: for organ donation, the waiting period is waived as long as insurance has been in effect for at least six months.)
Waiver of Premium
Once claim payments begin, any premium becoming due will be waived; no further premiums will be due while you remain disabled.
You'll have 24-hour/7-day a week protection, whether you are at home, at work, or on vacation anywhere in the world.
New York Life Insurance Company
51 Madison Avenue, New York, NY 10010
On Policy Form GMR-FACE/G-30639-0
Under Group Policy No. G-30639-0
You're eligible to apply for this plan if you're a physician under age 60 and actively engaged full-time in the duties of your profession.
All applications are subject to medical underwriting and approval. Any required medical exam will be conducted at your convenience and at no cost to you. Membership in the American Medical Association is not required.
Your coverage will be effective on the 1st of the month following the date your application is approved by New York Life Insurance Company. Coverage will be in force from the effective date provided you are eligible, actively at work, and premiums are paid when due.
Coverage terminates at age 75.
As long as you are a physician actively at work, under the age of 75 (not retired), pay your premiums when due, the group policy remains in force, and the AMA continues to sponsor this plan, your coverage can be renewed. Coverage will be terminated upon the suspension or revocation, or voluntary surrender in any state, of your license to practice medicine as a result of a criminal act, ethical violation or gross malpractice. You also cannot be singled out for a rate increase, regardless of how many claims you have made or the changing status of your health. However, rates may be adjusted on a class-wide basis. For example, a "class" may be a group of insureds of the same age group.
No monthly benefit will be paid for Disability due to:
- Intentionally self-inflicted injury or attempted suicide, while sane or insane;
- A declared or undeclared war or an act of war;
- The use of any narcotic drug or other substance which is (a) subject to the Federal or the various state controlled substances acts, unless the prescription shall have been written by an Attending Physician other than you, or (b) required by law to be dispensed by prescription only and used other than a bonafide medical purpose as it relates to you or for other than the treatment of an existing medical condition.
Benefits will not be paid, or accrued, for any period of time while you are incarcerated.
Benefits will be paid either for Injury or for Sickness, but not for both, during any concurrent period of Disability.
This plan is not currently available in:
NH, UT, VT, and WA
Group Disability Income Insurance is Underwritten by:
New York Life Insurance Company
51 Madison Avenue, New York, NY 10010
On Policy Form GMR-FACE/G-30639-0
Under Group Policy No. 30639-0
New York Life is licensed/authorized to transact business in all of the 50 United States, the District of Columbia, Puerto Rico and Canada. Not all group plans it underwrites are available in all jurisdictions. Please check the applicable insurance brochures for current availability. New York Life's state of domicile is New York, and NAIC ID# is 66915.
AMA Insurance incurs costs in connection with providing oversight and administrative support for this plan, and is reimbursed for these costs. The American Medical Association also incurs certain expenses in connection with the plan and is reimbursed for such expenses.
This website explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policy underwritten by New York Life Insurance Company. Exclusions, limitations, reduction of benefits and terms under which the policy may be continued in full or discontinued are detailed in the Certificate of Insurance issued to each insured individual and complete details are in the Group policy issued to the policyholder. This program may vary and may not be available to residents of all states.