AMA-Sponsored Disability Income Insurance

Monthly Benefit Amount Up to $15,000

Physicians under age 55 may apply for up to $15,000 in monthly benefits for total disability. Physicians age 55 to 60 may apply for up to $5,000 in monthly benefits. Benefits are payable regardless of whether your covered total disability is caused by accident, illness, or organ donation. Benefits from this policy, when added to any other disability insurance in force or applied for, cannot exceed 66 2/3% of your monthly income or $30,000, whichever is less.

Up to a 10% Rate Reduction

Members of the American Medical Association receive a 10% rate reduction.  Rate reductions are reviewed annually, and although not promised or guaranteed, premium credits have lowered the cost of this insurance since 2006.  Rates may vary by state of residence.

Choose your Definition of Disability

This coverage includes an “Own-Specialty” definition of disability, which means, benefits are payable if you are unable, as the result of a covered illness, injury, or organ donation to perform the duties of your own medical specialty and are not gainfully employed  even if you have the ability to work in another field of medicine. However, you can enhance the protection of this coverage by choosing the “True-Own-Specialty” definition of disability option to allow you to collect 100% of the monthly benefit if you choose to return to work in another occupation.  Additional cost applies.

Long-Term Benefit Periods

If you are disabled by accident, illness, or organ donation before age 62, benefits under this policy are payable up to age 67. If you are disabled at age 62, benefits are payable for up to 60 months. At age 63 and after, the benefit period is reduced by six months depending on your age at disability. From age 70 to 75, benefits are payable up to 12 months.

Benefit Period Limitation

If you are disabled due to mental, nervous or emotional disorders before age 69, benefits under this policy are limited to 24 months. At age 69 and 70, benefits are limited to 18 and 12 months, respectively.

Medical School Loan Payment Benefit – up to $200,000 if totally and permanently disabled

This benefit is available to physicians insured prior to age 40. This benefit could pay up to $200,000 of eligible student loans if you are totally and permanently disabled before age 45. This benefit is paid in addition to your monthly disability benefit and its’ included in your coverage at no additional charge.

Catastrophic Disability Rider

Increases your base monthly benefit by 30% if you become Totally Disabled and unable to perform two of six activities of daily living-bathing, dressing, toileting, transferring, eating, or continence. You will also be eligible for this benefit if your disability results in a Cognitive Impairment: the deterioration or irreversible loss of intellectual capacity. Benefit is available for 10% additional premium under age 60 (or 20% additional premium if age 60 and above). You must have a minimum of $3,000 in base benefits to elect the rider.

Cost of Living Adjustment (COLA) Option

For just 15% additional premium you may add the COLA option. With it, the monthly benefit payable for a covered total disability may be adjusted annually to reflect changes in the cost of living based on the CPI-U.* Years are measured from the start of the waiting period. In the first year, no adjustment will be made. Adjustments may be made to the monthly benefit paid in the second and each succeeding year. Note: If you choose this option in addition to the Catastrophic Disability Rider above, the cost of the COLA option will be an additional 1.5% in premium for a total of 16.5% (or an additional 3% in premium for a total of 18% if age 60 and above).

*’CPI-U’ means the Consumer Price Index for All Urban Consumers, All items, as published by the Bureau of Labor Statistics. If the CPI-U, in New York Life’s opinion, is no longer a valid index for the purpose of this Option, or is no longer published by the Bureau of Labor Statistics, they will use a new index.

Extra Benefits for Rehabilitation

To help you recover, you may also qualify for rehabilitation benefits in addition to your monthly disability benefit if you participate in an approved accredited occupational rehabilitation program while you are disabled.

Residual Benefits for Part-Time Work

Collect partial benefits, if you return to work part time in your specialty (true own-specialty definition) or collect partial benefits, if you return to work part time in your specialty or any other occupation (own specialty definition), provided you first qualify for a covered Total Disability and provided your monthly income is reduced by at least 20%. Benefits will be based on a percentage of your total monthly benefit.

Future Benefit Increase Option

If you are under age 40, this option may allow you a future increase in benefits with no health questions or medical exams required if your income increases and you remain actively at work. This one-time option must be exercised within the first three years of your original effective date and before your 40th birthday.

Communicable Disease Benefit

If you contract a Communicable Disease* before age 67, you may qualify for benefits without the requirement that you suffer a covered total disability. You’ll be eligible for this benefit if the illness causes you to earn less than 75% of your average monthly income for the period before your practice was limited and/or condition was disclosed as a result of contracting the disease.

*Communicable Disease means any of the following conditions, but only if: (a) the medical profession recommends; or (b) an appropriate governmental agency requires; the disclosure of the diagnosis of the Communicable Disease and/or a limitation of his or her practice due to contracting the Communicable Disease: Acute Viral Hepatitis of a non A type, Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS) or tuberculosis.

Family Care Benefit

This coverage will pay up to one basic monthly benefit to you to care for a close family member with a Serious Health Condition.* Your spouse or domestic partner; child, including a step-child, adopted child or child of your domestic partner; or your parents, are considered ‘close family members.’ The health condition must be certified by the family members’ licensed attending physician.

You must be working at least 20% fewer hours and have a loss of 20% or more of your average monthly income, due to the time off to qualify. The monthly benefit is the amount payable in proportion to the loss of monthly income up to a maximum of one basic monthly benefit.

0%-19%: No benefit
20%-25%: 25% of the Basic Monthly Benefit is payable
26%-50%: 50% of the Basic Monthly Benefit is payable
51%-75%: 75% of the Basic Monthly Benefit is payable
76%-100%: 100% of the Basic Monthly Benefit is payable

*Serious Health Condition is a condition that causes the family member: to be unable to complete, without substantial supervision, two of six ‘activities of daily living’ including bathing, dressing, toileting, transferring, (e.g., in and out of bed), eating and continence; to require substantial supervision due to severe cognitive impairment; to be hospitalized; or to become terminally ill with a condition that is reasonably expected to result in death within 12 months.

Layoff or Leave of Absence Benefit

Your insurance can continue beyond the end date of the coverage if you cease to be employed full-time due to layoff, leave of absence, or a leave of absence required by state law or by the Family and Medical Leave Act of 1993 (FMLA). Your coverage will continue for up to 90 days during a temporary layoff or a leave of absence other than state mandated leave or FMLA; or the greater of the period required by state law or by FMLA provided the leave authorization is in writing and required premium is paid.The insurance will then end on the earliest of 90 days after the temporary lay-off or leave of absence (other than state mandated leave of FMLA) began; the date the layoff becomes permanent; the date the state mandated leave or FMLA leave ends; or the date insurance would otherwise end.

Your Choice of Waiting Periods

Select a waiting period of 2, 3, 6, or 12 months. The waiting period is defined as the period of time from the start of a covered total disability during which no benefits are payable. Benefits are not payable if you work in any occupation during the waiting period. (Note: for organ donation, the waiting period is waived as long as insurance has been in effect for at least six months.)

Waiver of Premium

Once claim payments begin, any premium becoming due will be waived; no further premiums will be due while you remain disabled.

Worldwide Coverage

Subject to U.S. government regulations on restricted countries. You’ll have 24-hour/7-day a week protection, whether you are at home, at work, or on vacation anywhere in the world.  U.S. residency is required to maintain coverage.

30-Day Free Look

You’ll have 30 days to review your Certificate of Insurance. If you change you mind, just return your Certificate for a full refund of any premium paid without claim. Your insurance will then be invalidated.

You’re eligible to apply for this group coverage if you’re a physician residing in the U.S. under age 60 and actively engaged full-time in the duties of your profession.

All applications are subject to medical underwriting and approval. Any required medical exam will be conducted at your convenience and at no cost to you. Membership in the American Medical Association is not required.

Your coverage will be effective on the 1st of the month following the date your application is approved by New York Life Insurance Company. Coverage will be in force from the effective date provided you are eligible, actively at work, and premiums are paid when due.

Coverage terminates at age 75.

As long as you are a physician actively at work, as a resident of the United States, under the age of 75 (not retired), pay your premiums when due, the group policy remains in force, and the AMA continues to sponsor this policy and you have not received the maximum benefits payable under the policy, your coverage can be renewed. Coverage will be terminated upon the suspension or revocation, or voluntary surrender in any state, of your license to practice medicine as a result of a criminal act, ethical violation or gross malpractice.

Premiums increase on the renewal date on or immediately after the date you reach a higher age bracket. You also cannot be singled out for a rate increase, regardless of how many claims you have made or the changing status of your health. However, rates may be adjusted on a class-wide basis. For example, a “class” may be a group of insureds of the same age group.

No monthly benefit will be paid for Disability due to:

• Intentionally self-inflicted injury or attempted suicide, while sane or insane;
• A declared or undeclared war or an act of war;
• The use of any narcotic drug or other substance which is (a) subject to the Federal or the various state controlled substances acts, unless the prescription shall have been written by an Attending Physician other than you, or (b) required by law to be dispensed by prescription only and used for other than a bonafide medical purpose as it relates to you or for other than the treatment of an existing medical condition.
• A disability that does not require the regular care of a doctor.
• Any impairment which has been restricted from your coverage.

Benefits will not be paid, or accrued, for any period of time while you are incarcerated.

Benefits will be paid either for Injury or for Sickness, but not for both, during any concurrent period of Disability.

This coverage is not currently available in: NH and WA.