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Question about preexisting condition when exercising FIO on LTD.

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  • Question about preexisting condition when exercising FIO on LTD.

    I have a question about preexisting conditions and the future increase options for long-term disability.

    I have a LTD policy for $6k monthly benefits right now during residency with the option to increase the benefit amount to $20k at a later date. The only exclusions I currently have are mental and nervous. My question is, what happens if I develop a back injury while in residency, and then I increase my benefit amount to $15k when I get an attending job? Would back injuries be an exclusion on the additional $9k in benefits?

    If I injured my back 10 years later and became disabled, would I receive $15k in disability benefits or would I only receive $6k?

    Thanks in advance.

  • #2
    Future increases done through an FIO/GPI Rider require financial documentation only, your medical history since you placed your policy has no bearing unless you are already disabled. Even if you are already disabled, you cannot be given a new exclusion. The carrier simply does not have to pay the additional benefits following an increase if you apply while already on claim or in the process.

    So, if you only have a Mental Nervous Exclusion now then that is all your future coverage will have as well when increasing via your FIO/GPI Rider. Also, don't forget that your Mental Nervous Exclusion might even be able to be reconsidered, depending upon the offer you were given.

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    • #3
      Originally posted by Romberg45 View Post
      I have a question about preexisting conditions and the future increase options for long-term disability.

      I have a LTD policy for $6k monthly benefits right now during residency with the option to increase the benefit amount to $20k at a later date. The only exclusions I currently have are mental and nervous. My question is, what happens if I develop a back injury while in residency, and then I increase my benefit amount to $15k when I get an attending job? Would back injuries be an exclusion on the additional $9k in benefits?

      If I injured my back 10 years later and became disabled, would I receive $15k in disability benefits or would I only receive $6k?

      Thanks in advance.
      The real simple answer is that if it is not excluded on your initial policy it will not be excluded on the increases. Those are guaranteed without consideration of any new medical or advocation changes since the original policy was purchased.

      Scott Nelson-Archer, CLU, ChFC
      303-953-0263 Direct / [email protected]

      Comment


      • #4
        Originally posted by Derek True View Post
        Future increases done through an FIO/GPI Rider require financial documentation only, your medical history since you placed your policy has no bearing unless you are already disabled. Even if you are already disabled, you cannot be given a new exclusion. The carrier simply does not have to pay the additional benefits following an increase if you apply while already on claim or in the process.

        So, if you only have a Mental Nervous Exclusion now then that is all your future coverage will have as well when increasing via your FIO/GPI Rider. Also, don't forget that your Mental Nervous Exclusion might even be able to be reconsidered, depending upon the offer you were given.
        If I remember correctly OP is an anesthesia resident, in which case I doubt Mental nervous exclusion will be reconsidered

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        • #5
          What happens is if there was an exclusion to No benefit due to medication being taken at the time of original application but now there is no medication being taken then not only the new benefit but the original policy could be written with a mental nervous benefit included. Granted most contracts have a 24 month max benefit for M/N within that specialty.
          Scott Nelson-Archer, CLU, ChFC
          303-953-0263 Direct / [email protected]

          Comment


          • #6
            the FPO is one of the reasons it's good for residents to get DI before they graduate, for reasons exactly like this!

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            • #7
              Originally posted by Scott at MD Financial Services View Post
              What happens is if there was an exclusion to No benefit due to medication being taken at the time of original application but now there is no medication being taken then not only the new benefit but the original policy could be written with a mental nervous benefit included. Granted most contracts have a 24 month max benefit for M/N within that specialty.
              got it. the 24 max may be what I was thinking of- we cant get benefit until 65 for it

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              • #8
                Originally posted by Scott at MD Financial Services View Post
                What happens is if there was an exclusion to No benefit due to medication being taken at the time of original application but now there is no medication being taken then not only the new benefit but the original policy could be written with a mental nervous benefit included. Granted most contracts have a 24 month max benefit for M/N within that specialty.
                This is exactly my situation right now.

                Comment


                • #9
                  Thanks for all the answers. This is good to hear because I’ve been having some pain in my fingers, toes, and lower back, and I just didn’t want to shout myself in the foot if I went to see a doctor for it in the future.

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