Should I Pay For Private Disability Insurance In Osceola, Florida?

Private disability insurance, for individuals or groups, can seem like a tempting safeguard against misfortune. Make sure you understand it, though, as attorney CJ Henry explains.

Few families in Osceola do not know someone who is or has become disabled. The fragility this can bring to a family, especially a working-class one, is brutal, and you might want to do everything in your power to avoid it or plan for the possibility. That is certainly the pitch Private Disability Insurance providers will give you to try to get you to buy into a plan.

Private disability insurance works a lot like social security disability, but with significantly less government intervention and oversight. It works by having you sign up and pay into a plan (either as an individual or group), and then, theoretically, it pays out if you ever become disabled. On paper, it works faster than Social Security Disability Insurance (SSDI) and can provide a higher income than government disability would, but in practice, there are a lot of catches and caveats.

As a disability attorney in Central Florida, Claudeth Henry has seen her share of denied claims and disputes, and, unfortunately, more denied or complicated private insurance claims than straightforward ones.

Private Disability Insurance Basics: Individual Vs Group Coverage

In the private disability insurance industry world, which happens to fall outside most regulations placed on insurance companies (foreshadowing), there are two main kinds of disability insurance: individual and group. Individual private disability insurance is coverage you purchase just for yourself, and falls under Florida laws, while your employer or a professional association usually organizes group insurance, which falls under Federal laws.

Of the two, employer-provided group insurance is by far the easiest to obtain in Osceola County, as it is sometimes offered as a bonus incentive and does not have to be underwritten. This means the insurer is not going to comb through your medical records for reasons to deny you coverage or hike up the price. However, it can be vulnerable to improperly filed paperwork, as employers may forget to do something, only for you to end up high and dry without the insurance you need if you become disabled later.

Denials are, unfortunately, also common with individual disability insurance, though the more scrupulous insurers will be up front about their conditions and refuse to write you a policy; the less scrupulous will wait until you have paid into it for years and deny you just when you need it most. On the other hand, it is easier to challenge an individual private disability claim denial because you do not have to exhaust all internal administrative remedies in a timely manner first, like you do for a group claim denial.

Two Questions To Ask Before Purchasing Individual Private Disability Insurance

CJ Henry Law Firm, PLLC | Osceola County, Florida, Private Disability Insurance

Private group disability insurance is rarely a choice, as you are most likely to get it through your employment.

That said, if the policy requires you to keep paying should you change employers or leave the workforce before becoming disabled, you might need to think about it just like an individual policy.

Thinking carefully is vital when making such an important decision. To help you do so, Osceola County disability lawyer (and former registered nurse) Claudeth Henry has put together two key questions to ask yourself and your insurance provider before signing anything.

What Disabilities Does This Private Insurance Cover?

“Will this policy cover me if I become disabled?” is a vital question, to which you might hope the answer is obviously “it certainly should, I paid for it!” but unfortunately, it is rarely so straightforward. As with any contract, you have to read the fine print.

Many private disability insurances will not, for example, cover mental illness disabilities, and they may deny you for any number of possible reasons, from incorrect paperwork to pre-existing conditions. This is especially true for group insurance, where they have not done much research into your medical history beforehand.

To answer this, you need to dive into the definition of disability used in the policy and any exceptions (such as those for mental illnesses). Most of the time, they will use the same standard as Social Security Disability, which means you have to be completely unable to work ANY job, not just the one you had before in Osceola County.

How Much Benefit Will The Private Disability Insurance Offer?

By far one of the most important questions to consider, however, is: how much is this insurance going to pay me if I become disabled? Assuming it does pay you anything at all (see above).

First, you need to look at how much you will be paid if you do become disabled. Many plans will have clear guidelines based on your previous income, but some might have caps or be fixed. You also need to carefully examine how that percentage is calculated, and how it will interact with non-standard income streams (such as owning a business or being self-employed).
Second, you have to consider the interaction with the Social Security Disability Insurance (SSDI) benefits and how that affects the potential payout. If your income was already low, your private insurance is not likely to be willing to pay you much on top of what Social Security is paying out (is it unfair, absolutely, but that won't stop them).
Third, you need to very carefully consider the benefit term, which is how long the insurance will pay out. If it will only pay for 5 years, or stops when you reach retirement age, that might mean a very low potential payout, and make the purchase not worth it.

If the amount you pay in will be greater than the amount you can claim, then there is no doubt you should refuse, and are better off simply saving the premiums you would otherwise pay for the rainy day eventuality of disability.

These questions can only take you so far, however, as everyone’s situation is different. If you are not sure about a private disability insurance offer, you should reach out to trusted financial advisors or attorneys for guidance. If you do not, you might end up paying for a claim that gets denied anyway, and have to go to court to even have a chance of obtaining the benefits you need.

Fortunately, if you do get denied in Osceola County or anywhere in Central Florida, we can help.

Call For A Free Consultation(352) 577-7746

My Private Disability Insurance Claim Was Denied. What Should I Do?

Call the CJ Henry Law Firm, PLLC | A Osceola County disability partner ready to protect your benefits!

All too often, private disability insurers will find ways to back out of paying when you finally need them to. Such denials can feel like a betrayal (and they are), but you must not give up or give in to anger. By acting fast and contacting a skilled disability lawyer, you can challenge the denial and appeal, or even sue the insurer for bad faith or erroneous denial.

In Osceola County, or throughout central Florida, that attorney is Claudeth Henry, whose prior experience as a registered nurse has given her keen insights into the workings (and failings) of the disability and insurance system.

To secure a free consultation to go over your claim or denial, just call
(352) 577-7746 or contact us through our website, and together we will do whatever we can to protect the benefits you paid for when you so desperately need them.