Home Health Insurance DIAM: Speaking of Awareness

DIAM: Speaking of Awareness

by Insuredwell
0 comment
Our friend Bernie Flatters has some follow up questions:

How old is the delivery driver? And what is the chance that she will qualify for SSI? Will her insurance benefits be reduced by SSI benefits? Maybe there should be an insurance product that covers day one until SSI benefits kick in. And maybe it pays for a high power attorney to argue her case.”

In the example in that initial post, we posited a 40 year old applicant. The real life example we used in a subsequent post is actually a bit older (not that it’s really all that relevant).

I presume that the dearth of zero-day elimination period individual DI plans is cost; that is, carriers can make the numbers work on short term group plans because of the much shorter benefit period (6 months) and lower benefit limits (usually capped at 60%, versus 65% or even 70% for individuals)..

Guessing that the “high power attorney” suggestion was a throwaway line.

So, not a lot there, but his Social Security Security (SSDI) questions are spot on, and I’d like to address those:

The odds of this client qualifying for SSDI would depend, of course, on the nature of her disability:

The law defines disability as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”

So in our example, we postulated that her most likely cause of disability would be some kind of accidental injury (such as dropping a keg on her foot, or straining her neck or back). It’s unlikely that these would result in death, but perhaps might last a year (or more).

Let’s assume the latter, and move on:

Social Security disability applications face an overwhelming 70% denial rate upon initial evaluation.”

And it gets better (for values of “better”)::

At the initial stage, a Social Security Disability claim may take an average of just over three months to process. Reconsiderations make take another two months of processing time, while the wait for a hearing date in front of a judge can take more than two years.” [emphasis added]

And yes, the plan I quoted is integrated with SSDI, which helps to keep the premium down some. I don’t see this as a problem, since it’s unlikely that the benefit period would outlast the actual disbursement of SSDI funds.

So, once again, Thank You, BF, for your great questions!

You may also like

Leave a Comment