Frequently Asked Questions
#1
What is the Monthly Earned Income?
This is the gross income from any wages, salary, fees, retainers, bonuses, commissions, and other income received from performing the material and substantial duties of your regular occupation. If you own a business profession, this income also includes your share of the business profit or loss (after deduction of usually and customary business expenses defined as those expenses that are deductible for Federal income tax purposes) in the final year immediately prior to your disability.
#2
What is the Monthly Benefit?
This is the amount paid for Total Disability which begins before the Insured attains age 70. After satisfaction of the Elimination Period, benefits will be paid monthly until the Insured is no longer Totally Disabled, or until the Maximum Benefit Period ends, whichever occurs first.
#3
What is the Waiver of Premium?
Waives the Contract Premium for the base Policy only if Total Disability begins before the Insured attains age 65. The base Policy Contract Premium is first waived after 90 days of Total Disability, or after satisfaction of the Elimination Period, whichever is later. The base Policy Contract Premium will continue to be waived until the Insured is no longer Totally Disabled, or until the Maximum Benefit Period ends, whichever occurs first.
#4
What is total disability?
Means because of Injury, Sickness, or Nervous or Mental Disorder: A) during the first 24 months of disability, the Insured cannot perform the material and substantial duties of his or her regular occupation, and must be under the care of a Physician, unless the Physician certifies that the Insured does not need the regular care of a Physician for such disabling condition. B) After 24 months of disability, the Insured is completely unable to perform the material and substantial duties of any occupation for which he or she is reasonably fitted by education, training, or experience, and must be under the care of a Physician, unless the Physician certifies that the Insured does not need the regular care of a Physician for such disabling condition.
#5
What is partial disability?
Means the Insured cannot perform one or more Important Duties of his or her regular occupation, and must be under the regular care of a Physician, unless the Physician certifies that the Insured does not need the regular care of a Physician for such disabling condition.
#6
What is presumptive disability?
We will presume you are totally disabled under the following conditions: Irreversible loss of speech and hearing, sight in both eyes, both feet amputated at or above the ankle, both hands amputated at or above the wrist or one hand and one foot. We will pay the monthly benefit immediately for the maximum benefit period shown on the policy schedule whether or not you are able to work. The elimination period requirement is waived.
#7
What is pre-existing condition?
A pre existing condition means a sickness or injury for which the insured has consulted a physician or received any medical advice, treatment, medical supplies, prescription medication or services within 12 months immediately before the effective date of insurance, or for which symptoms of a condition have occurred that would have led a prudent person to seek diagnosis, care or treatment during the 12 months immediately before the effective date of insurance, or until the insured has been covered for 24 months.
#8
What is benefit reduction for other coverage?
If the Insured has any Other Disability Income Coverage in effect at the time Total Disability begins, the benefit provided by the Policy will be reduced to the extent this coverage, plus all other coverage, together exceed 100% of the Insured Monthly Earned Income.
#9
What is other disability income coverage?
Means benefits similar to this Policy, provided by individual, group or blanket-type insurance, labor-management trusteed plans, union welfare plans, employer or employee benefit organization plans, government agencies or organizations, salary continuance or pension programs, and any other arrangement of benefits for individuals, including benefits under any state law or federal Social Security. Benefits will not be reduced when Social Security has a general level increase in its benefits. Social Security benefits payable to or on behalf of the Insured dependents are not included in this reduction.