PROVIDER PLUSOther Policy Benefits |
Interrupted Elimination Period (Return To Top)
All disability income policies have an elimination period - that is, the period of time that must elapse before monthly benefits begin.
We will allow different periods of disability, from the same or a different cause, to count towards the elimination period (EP), which must be satisfied within the accumulation period specified on the policy schedule page. The days on which you are disabled need not be consecutive, and if your policy has a three-month elimination period, for instance, the accumulation period (during which you need to accumulate those three months of disability) would be seven months.
As this chart shows, even though the second disability isn't related to the first, we do not apply a new elimination period for the second disability. Many other companies require the second disability to be due to the same or related causes. If it isn't, they apply a new elimination period.
Scenario:
- $5,000 monthly benefit
- 3-month elimination period (EP)
- A heart attack disables you for two months
- Four months after you recover, you are disabled by an automobile accident
In this scenario, the Provider Plus policy will pay out $10,000 more in benefits - and sooner - than many other companies.
Waiver of Premium (Return To Top)
During disability:
- Premium is waived after three months or the elimination period, if that's shorter;
- Premium is refunded if it was due and paid during the elimination period
- Premium may be waived for 12 months if you are disabled on a policy anniversary; and
- Premium is waived for three months after recovery.
The Provider Plus Waiver of Premium benefit is important because it waives premiums that fall due during a disability and refunds premiums that were due and paid during the elimination period. If you select the Residual Disability Rider, you may be either totally or residually disabled to qualify for Waiver of Premium. To become eligible you must be disabled for three months or the elimination period, if that's shorter.
Your premium will continue to be waived for three months after you recover. If you are disabled and eligible for premium waiver on a policy anniversary, we will waive an annual premium even if you paid your premiums more frequently. The waiver continues until the next policy anniversary, even if you recover sooner.
The waiver of premium benefit will also apply if monthly benefits are payable because you have met the requirements of any of the provisions called Waiver of Elimination Period, Recurrent Periods of Disability or Presumptive Total Disability Benefit.
Our Waiver of Premium means extra cash to help pay expenses during a disability.
Waiver of Elimination Period (Return To Top)
Under a unique feature of the Provider Plus policy, there is no new elimination period for subsequent disabilities from any cause, if your original disability lasted at least six months and you received any benefits from us. (The second period of disability must occur within five years of the first.)
This means that benefits would be paid from the first day of the second period of disability, even if the subsequent disability were for a minimal period of time or was caused by an accident or illness not related to the first period of disability. What does this mean in real dollars?
Scenario:
- $5,000 monthly benefit
- 3-month elimination period
- You are totally disabled for six months and then recover
- Within five years you are again disabled - from any cause
Because of this policy provision, we could pay up to $15,000 more than most other companies since we would pay from the first day of the second period of disability. Most other companies would require another elimination period before starting payment again at the 39th month. The result? We pay more money and pay sooner on a second disability.
Presumptive Total Disability Benefit (Return To Top)
ProVider Plus includes a benefit designed to give you extra protection in the case of certain catastrophic disabilities: the Presumptive Total Disability Benefit.
Because of this benefit, we will consider you totally disabled if sickness or injury results in the total and complete loss of: the sight of both eyes; the hearing of both ears; the power of speech; the use of two arms, two legs, or one arm and one leg, in their entirety. We will also waive any unexpired part of the elimination period from the date of such a loss.
Suppose you suffered compound fractures of both legs in an auto accident. Since you have experienced the total and complete loss of their use, we will waive the elimination period and you would receive benefits from the date of that loss. Most other companies would not consider this a presumptive disability and therefore would not pay until after the elimination period if you were still disabled and you met the definition of disability. Even if you continued to work full time with compound fractures of both legs, we would presume you to be disabled and would pay your monthly benefit until your recovery.
The bottom line is that on a policy with a $5,000 monthly benefit and a 3-month elimination period, we could pay you up to $15,000 more in benefits.
Capital Sum Benefit (Return To Top)
The Provider Plus policy also includes a lump sum benefit for other specific losses: the Capital Sum Benefit.
This benefit is paid in addition to any other benefits payable if, because of a sickness or injury, you lose the entire sight of one eye with no possibility of recovery; or suffer the complete loss of a hand or foot severed through or above the wrist or ankle; and you survive it for 30 days. The Capital Sum equals 12 times your monthly benefit, so on a policy with a $5,000 monthly benefit, we would pay $60,000 for such a loss. No more than two such losses are payable during your lifetime.
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