Even after reopening on a full-time basis, the profitability is likely to be reduced substantially. The loss of income experienced after an extended disability can continue for months, years and possibly be indefinite. For this reason, the benefit period available for recovery benefits requires careful consideration. Call or submit a quote request today. Our firm represents the leading disability insurance providers and can assist you in evaluating your options and ultimately applying for the policy that best suits your needs.
All scenarios and names mentioned herein are purely fictional and have been created solely for training purposes. Any resemblance to existing situations, persons or fictional characters is coincidental. The information presented should not be used as the basis for any specific advice.
We do not share or sell your information. Paul Revere Life Insurance Co. The case involved William Simmons, a year-old dentist who practiced in Seattle and Bellevue, Wash. Following the accident, Simmons was able to maintain a regular dental practice, although he ceased performing certain services such as wisdom tooth extraction, crown and bridge work and periodontal surgery due to his shoulder. In , Simmons filed a disability claim with his disability insurer, Paul Revere, which found him residually disabled except for a short period of time when he underwent shoulder surgery and recovered from that procedure.
Simmons filed suit challenging the denial, but the court ruled against him. Simmons argued that because he had purchased a rider providing for total disability in his own occupation, since he was unable to perform all of the duties he performed prior to his injury, he should be found totally disabled. Unum Life Insurance Company of America disagreed and asserted the rider had to be read in conjunction with the residual disability provisions of the policy. The court cited numerous rulings from around the country that it viewed as being consistent with its finding, which included Dym v.
Provident Life and Accident Insurance Co. Partial disability benefits are generally fixed at a certain percentage of the total disability benefits amount, and are therefore income-independent.
By contrast, residual disability benefits are fundamentally dependent on income, and dynamically changes in accordance with income.
Due to your partial disability, however, your income drops 25 percent. Generally speaking, partial disability benefits coverage lasts for a short period of time, oftentimes just a single year. By contrast, residual benefits may payout for a lifetime, depending on the plan.
Residual benefits are intended to fill gaps in insurance coverage that might otherwise give rise to no recovery in edge cases where you are not rendered totally disabled, but where your overall income and career have still been affected. We believe that effective representation is that which focuses on the individual — as such, we work closely with clients throughout the litigation process and maintain open and transparent communication at every stage.
Qualifying for Benefits Whether you actually qualify for residual benefits depends on the particularities of your insurance plan — there is no universal, consistent baseline for residual benefits, as plans can vary quite substantially.
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