Disability insurance on mild apnea

Posted: Tue Aug 17, 2010 06:15 am Post Subject:

I guess the best way to go about it would be to consult a qualified agent. Let him speak with a couple of underwriters regarding your issues before you sign up. It will give you a fair idea of the company that will work to your interests.

Posted: Wed Aug 18, 2010 02:01 am Post Subject:

Sleep apnea does not directly cause disability, but it can and does cause death. It is unlikely to affect one's acceptance for a disability income policy, but it could affect one's acceptance for either life or health insurance.

It is possible to submit "trial balloon" applications to see exactly how underwriters would deal with your condition.

Posted: Wed Aug 18, 2010 05:38 am Post Subject:

It is possible to submit "trial balloon" applications to see exactly how underwriters would deal with your condition.

Posted: Wed Aug 18, 2010 11:15 pm Post Subject:

Some insurance companies will accept applications for underwriting on a COD basis -- no coverage under a conditional receipt. If approved, the client may choose to accept or decline the coverage.

Mostly, however, this is accomplished through the use of an IMO to do independent underwriting and then shop the coverage to the most likely companies to accept the application.

Posted: Thu Aug 19, 2010 12:40 am Post Subject:

Max, I assume that you don't sell much in the way of disability coverage. Sleep Apnea can absolutely be a huge issue with disability coverage. I don't know what is meant by "directly cause disability". One isn't disabled because they have sleep apnea. However, one can be disabled because sleep apnea is causing them not to be able to get sleep which stops them from being able to do their job.

Blueinsky, assuming that you have no other health issues and the sleep apnea is indeed mild, the expectation should be that you can get coverage, but that you will have a sleep disorder exclusion.

Use an independent agent who can do his homework to find the best company for your situation.

Posted: Thu Aug 19, 2010 02:42 am Post Subject:

I think the concern may not be about purchasing DI coverage, but maybe on the claims side of things. If the OP is wondering about whether the apnea will allow him to make claim, there's no way we can answer that here without a bunch more info.

Coverage under DI contracts is purely based on the definitions contained in the policy. You'll have to look at the contract to see what can trigger coverage. You'll see all sorts of stuff, but you need to look for their definition of disability. Most contracts base coverage on a "reasonably suited" definition, but you'll see "any" and "own occupation" and other stuff that can confuse you even further. There are normally waiting periods associated with LTD claims, commonly 3-6 months.

Those of you with DI knowledge, don't launch into a massive dissertation on the potential conflicts with the coverage definitions- you'll confuse the snot our of the OP.

OP-------> read the policy thoroughly. If it's a group policy, your employer should have the "master" contract that governs the group coverage.

InsTeacher 8)

Posted: Thu Aug 19, 2010 03:59 am Post Subject:

Yeah, as Ins Teacher stated, it doesn't look like the OP is looking for coverage, but rather how sleep apnea could effect claims on a group LTD policies. It's rare to see individual coverage referred to as LTD.

Also as Ins Teacher stated, you'll need to look at the definition of disability. It'll like say something like:

"You are considered completely disabled when you lack the ability to perform the material and substantial duties of your occupation [this part is usually always there, the next part is what makes them differ]."

After that, you might also find something like:

"and any occupation for which you are appropriately licensed or trained."

This would be the boiler plate wording of any occupation coverage. It means that if you can't do what you do know, but you can do something else and earn 60% of your original income, you won't be receiving any benefit from your group LTD.

If your definition lacks that second part, or says something like:

"You are considered completely disability when you lack the ability to perform the material and substantial duties of your own occupation and after (X amount of year) the ability to perform the duties of any occupation for which you are appropriately licensed or trained."

There's a chance you could receive benefits for at least a few years, even if you could work somewhere else.

To get back to what I think is the original question (will sleep apnea put you on claim), I think the answer depends on what a doctor's review says of your condition and what you are able to do for work as a result of that review, compared to what the definition of disability is in your group LTD policy.

Posted: Thu Aug 19, 2010 05:54 am Post Subject:

Hi all, this is what I was looking for. When I had mild apnea diagnosed, I was placed on Cpap for some time. It had some thing to do with my weight, so I had to lose weight. Since then I not in Cpap anymore. Apnea is no more an issue with me. I'm also wondering if it will affect my eligibility for LTD coverage!

Posted: Fri Aug 20, 2010 12:08 am Post Subject:

My first answer stands. You can probably get coverage, but there is a good chance that sleep disorders may be excluded. It depends upon the specifics. A good insurance broker can help you.

Posted: Fri Aug 20, 2010 12:11 am Post Subject:

If the question was being as a claim's question, the answer is that disability isn't defined by a condition. In other words, "sleep apnea" or "cancer" or "heart disease" doesn't make one disabled. If those conditions impact one's ability to work, one might be disabled, but it will completely be dependent upon the language of the contract.