larry ep 1

Okay, welcome back to Behind the Knife. Uh, this is Kevin here and I'm lucky enough today to have Larry Keller with me. Larry Keller is an insurance agent out of New York and he has all of the qualifications to include C-F-P-C-L-U and a bunch of others. And he is, uh, a true expert at basically any type of insurance that a doctor would need.

And there's been a lot of changes in the insurance industry as of late. And, uh, we had 'em on previously to learn a little bit about disability, a very important thing for us, especially US surgeons. And, uh, today we're gonna have, it's be a part one of a two part episode where the first one we discuss sort of the basics of disability insurance.

And then the next one we talk about, uh, guaranteed standard issues. So make sure you listen to our second podcast to learn about guaranteed standard issue. Uh, but Larry, if you can take it away and tell us about why buying an insurance policy and picking the right one is as easy as 1, 2, 3. So it's, I'll tell you, if you guys can do medicine, especially surgery, you know, buying long-term disability insurance,

you know, really is pretty easy.

And I know of all the consumers that are marketed to, I would say physicians and dentists are probably the number one and number two, you know, in that order. So let's say. Disability insurance is something that you're thinking about, and disability insurance really just protects your income and gives you money in the event you're too sick or too hurt to work.

That is really what disability insurance comes down to, and unless you have a significant amount of money, put aside. Buying disability insurance is one of the most efficient ways to actually go out and protect your income. 'cause especially if you're early in your career, Kevin, we know this. I mean, the majority of your assets is really you.

It's all in your head and it's all in your hands. And you've spent a tremendous amount of time and money in your education, your training, and your experience. And if something goes wrong, whether it's an accident

or a sickness. Even the best laid financial plans will come to a screeching halt. Yeah, absolutely.

I, I can tell you, I remember as an early trainee thinking, um, you know, I feel great. Like, I don't, I mean, even by the second year, first year of fellowship, you know, vascular surgeons, we wear headlights, we wear loops. We were lead. I was starting to have some aches and pains and, um, it really made me happy that I, you know, was protected.

Um, and so, um, I think this is, I am sure it's per pertinent for all doctors, but especially surgeons, uh, protecting all the work that we've put in. Um, I is such an important thing. So now we go out and we say, you know what? These guys seem to make sense. We got a vascular surgeon, we have an insurance guy, uh, out there.

You know, what do I actually do if I'd like to explore long-term disability insurance, I. So the first thing that we might do is see if our employer is providing us with any coverage. And we know the

majority of residency and fellowship programs aren't going to give their trainees long-term disability coverage.

Uh, most of the hospitals or large employers or multi-specialty clinics are also going to provide long-term disability coverage for their attending physicians. So where that is good. I wouldn't necessarily say I would want that to be the foundation of my coverage because if I leave that hospital or I finish my training as I will, typically that coverage is not going to come with me.

If I'm hurt on the job and I receive benefits for workers' compensation, you know, that will offset my benefit If I'm really disabled and I'm receiving Social Security disability benefits. Generally that's going to offset my employer's long-term disability policy. And then if I'm not a trainee and I'm actually practicing, one big thing about group insurance is

it's limited.

So it might say something like, well, Kevin, if you were an active duty and you were working for a large medical center, uh, we're gonna give you 60% of your salary with a maximum monthly benefit of X. So let's say that that X is $10,000. 60% of what number is going to give me $120,000 a year, which is $10,000 a month, and the answer we know is 200,000.

Well, we also know typically if the insurance is being provided to you by your employer. They're gonna take an income tax deduction for the benefits that they're providing to an employee, which is you. And as a result of that, short of them adding the premiums that are being paid on your behalf back to your taxable income, that benefit becomes taxable to you.

So now I'm at 60%, but it's only 60%, which was protecting an income of 200,000. Wait a second. I'm earning a lot more than

that. I have no protection for that excess. Even that 10,000 a month that I'm getting, that's a taxable benefit and 60% is less than a hundred percent. Where is that additional money gonna come from?

So your individual plan is typically used to make up for the taxes that you might lose on a group insurance plan, make up for the earnings that you have in excess of this cap. And then in the event you were to change jobs, this is your individual portable policy that you take with you. So that's the main reason that you're looking for an individual policy.

So now you go to the internet, right? That's what we all do. It's time for me to do some homework. I type in disability insurance for our vascular surgeons. I type in disability insurance for physicians. I step to see a whole bunch of sponsored ads, but then I also see a whole bunch of websites that say, request a quote.

So I do that. I start requesting quotes from multiple agents that are on the internet. I don't necessarily know who these agents are, but they're gonna be able to at least get me started in terms of a cost versus a benefit. So other than price, which is what we all know. Really, where should we start? And I always say, let's start with the end in mind.

What is it that I think I wanna buy? And rather than focusing in what's the same, let's focus in on what's different. 'cause that's gonna leave me potentially from, I like policy A. I don't necessarily like policy B, so we'll focus in on these differences first. Then we'll come in, we'll talk about what is similar, and then we can pivot to that second episode, which is really gonna be important for residents, fellows, and recent graduates.

Talking specifically about guaranteed

standard issue or GSI disability insurance, where you can buy that regardless of your health. There's either no medical questions at all, or maybe there's a couple of gatekeeper questions just to. Make it a barrier to entry, but it's not like fully underwritten where you're applying, you're answering medical questions.

Uh, behind the scenes there's a prescription drug canvas, so we could see, I. What you're taking, and we can ask you why you're taking that. Uh, we can request a copy of your medical records. There's a HIPAA compliant authorization in there, and we can see what you have seen your physicians for. We can learn about your prior medical history.

We can learn about surgeries, uh, that you might have had. So this allows you to bypass that step almost entirely and lock into a very high quality policy. At a discount. So I go to the internet, I've got these agents sending quotes to me.

Uh, the first thing that I would say you should know is you are better than a spreadsheet.

You are a physician. You are a surgeon. You are at the top of the food chain, and you can basically have any insurance agent that you want go to work on your behalf. But what do you get? You get a spreadsheet, which has the company logos on it. A grid as to how one policy might compare to another on a very limited basis, and it really sign signifies what an insurance agent might think is important to you, but it might not be at all what is important to you.

So without necessarily knowing what to ask, you might ultimately make a very important decision based on very limited information. So we wanna avoid that. I mean, Kevin, I guess it's almost like going to one of your patients, telling 'em you're gonna wheel them down to the operating room and by

the time they're done, they're gonna come out great.

But you didn't necessarily explain to them the complications of the surgery and the risks that go along with it. If you did, I'd like to think they'd still go with you. Maybe they would take a pause and say, maybe I should ask him something else. Or what are the complications associated with this procedure Potentially do, do you recommend, uh, getting multiple quotes from multiple agents?

Um, I generally don't. I mean, what you'll find is this is disability insurance and life insurance. It's kind of like an iPhone, like the price is the price, and the only way that one agent can beat out another is to know of or have access to an exclusive program, like a guaranteed standard issue plan or an exclusive discount.

Otherwise, if two different agents structure the policy the same way,

they're gonna come back to you and the cost is going to be exactly the same. Now, you might find. Agents are not all created equal. You might find that one agent has been in the industry a lot longer. They have a lot more knowledge compared to another one.

You might find that the personality of one agent gels with you a lot more than the personality of another agent. But from a product standpoint, for the most part, the price really is the price. So someone could come to someone like me. That's been doing this a very, very long time and, and is very experienced.

Or they can go to, you know, their friend from high school that's been in the industry for, you know, all of three weeks, they're calling on their friends and family members. They saw that you're a physician, they're all excited and the price is gonna be the same, but the experience might actually be very different.

And so, so how do you know, uh, that you're choosing, you know, an advisor that

you can trust? Well, a lot of times it comes down to like, you'll ask for referrals from, you know, friends and colleagues. Um, if it's me, I would ask, well, what are your credentials? You know, how long have you been doing this? How many people do you work with?

In my medical specialty, how many physicians do you have as clients? Are there specialties that you tend to like to work with more than others? Right. And then I would go with this. Experience dictates. So there was a study done, uh, it's basically like the agent and financial professional retention study, and the last one that was done, I believe was 2022.

And we looked at it and we said, for every hundred agents that come into the financial world, 85 of them are gone within the first four years. Now imagine if medical school was like this, like your class of a hundred, I would

say, what 95 are gonna graduate? The, the five that didn't? Maybe two thought it was too difficult, they just couldn't hack it.

Uh, one wanted to be a dentist, one wanted to be an MBA, and one wanted to go be an attorney. And they knew right away this was not right for them, but. Once you graduate, the odds are very good that you're going to match. You are gonna practice medicine and surgery in some way, shape, or form, and you're off and running.

It's unfortunately, it's just not the same in the insurance and financial planning industry. So you're right. A lot of it is who are you talking to, and a lot of times, unless you know the questions to ask or you do your research. You don't know. In fact, there's some pretty well known websites that are out there, and you look for the agents, and there's no biographies there.

There's no names of the agents. So you are just requesting quotes from

some nebulous agent that you don't know what you're gonna get, and that's a real problem. So other than price, other than quality of agent or experience. Here are some things that you should know. So the first one is pretty big these days, especially post covid, is how are claims handled when they're related to mental or nervous conditions or substance abuse disorders.

So I know Kevin, when I think mental or nervous conditions, I don't think like a physician, I think like an insurance guy. So to me, a mental or nervous condition is anxiety, depression, stress, chemical dependency. I. Drug addiction or burnout? Well, in a lot of cases, depending upon the state that you're in and the company you're looking at, I might have a choice where I can have a policy that has a limitation for these psychiatry

based claims, or I can choose unlimited coverage for psychiatric based claims.

So if I'm okay with a limitation and I look at it and I say, I've made it this far, I. I haven't had any issues yet. I don't expect to have any issues. If I can save a little bit of money by having a limitation for these types of claims, I am willing to bear that risk. And typically you're either gonna get paid for 24 months over your lifetime or 24 months per episode of disability.

The really bad stuff is not going to be limited, even if you opted for a limitation. So dementia as a result of a stroke, a trauma, head injury, viral infection, Ms. Parkinson's, I can no longer do vascular surgery because of a physical condition, and now I'm depressed. Well, that's not good, but your physical condition is what's

causing your inability to do your job.

Your benefit is not going to be limited, but note short of A GSI plan, if you have A-D-D-A-D-H-D, if you're in therapy, if you're taking an SSRI likely you are going to get an exclusion rider on your policy where we tell you, based on your medical history, we are not going to provide you with any coverage.

For claims resulting from mental or nervous conditions that are psychiatric based. So just be prepared for that. Does that make sense? Yeah, I have, I have one slight question that kind of goes back to the previous point we were talking about. Is picking the right insurance agent important because they can help you navigate getting a claim?

Should you need one? Like is that part of your job or is that not part of your job? It's part of the job. I mean, experience will dictate. You know, a lot of times the insurance

companies really don't want the agents or brokers involved in the claims process because we're always gonna take the word of our client over that of the insurance company.

But we're certainly there to assist in the claims process. We can very often tell a client, well, these are the provisions of your policy and based on what you are describing to me. This is the way your policy might pay you. Uh, we'll usually get you the claim forms or get the claim forms sent out to you.

We'll ask you about what happened, you know, accident or sickness. Uh, when did you last work full time? When did you go back to work or you were able to work on a limited basis? And that will tie into some of the policy provisions. So I think an experienced agent can really never hurt you. It can only help you, not only in navigating the policy to buy.

Going through the claims process. 'cause we've typically done this

multiple times for multiple clients. And if it's the first time, again, the odds are good, you're probably not gonna have the same experience dealing with someone that's inexperienced or newly minted compared to someone that is very experienced,

right? So in that mental nervous world. Let's assume that you have the ability to buy unlimited coverage, or you can choose to opt for a limitation. It's probably gonna be one of two schools of thought. Number one is, I made it this far. I don't have any issues. I have no personal history, I have no family history.

I'm gonna be okay with a limitation. That's the route that I'm gonna take. Now, typically, you have a choice. Except if you're in California, the state of California, every policy has a limitation. And the state of New York, uh, one company only has a limited option. So if you want unlimited, you

probably wouldn't buy from that company.

Or you might say, you know, if the difference is 10% or 15%, essentially I'm giving up the discount for the limitation. I don't know what I don't know. I'm buying it for the unknown. I would just assume have unlimited. The other times that you see unlimited not being available is typically to anesthesiologists and emergency medicine physicians, just based on prior claims experience history for those medical specialties.

Make sense? Yeah, no. Sounds good. And uh. Is it? Is it typically what, like I think even my policy, like typically two years is the typical mental nervous substance abuse. Like is that kind of a okay statement? Yeah. Yeah. I would say that that's the general rule and then you can opt for unlimited if you want that.

Uh, some companies come with the limitation and like I said, you can opt for unlimited.

Some come unlimited, and then you can opt for the limitation and the savings that goes along with it. And again, your worst case scenario is if you do have a medical history in that mental nervous area, even if it's just, you know, general anxiety, depression, A-D-D-A-D-H-D, then you're likely going to get an exclusion rider for those types of claims regardless.

And then you really don't have a choice. And Larry, uh, have we talked about, uh, own occupation yet and what that means? Uh, we're gonna come back to that in the similar area. Okay. We're gonna go with the next one, which is in the area where things might differ. So the second one is, well, how are claims handled if you're disabled and you choose to reside overseas?

This could become really, really relevant for those that have a visa, right? An H one B or a J one Visa.

So for the most part, if you are a visa holder, the insurance companies are either not going to pay benefits outside the United States or Canada, or they're going to specifically state, we will not pay benefits in your country of citizenship.

So in the event you lost your sponsorship, your Visa is now gone and you have to return home. Your best case scenario is your benefits are typically going to be limited. Now, guardian, which is a unique company in the fact that they say if you're in all but a handful of states, they will give you a policy and that policy is essentially gonna say, Kevin.

Because you're a visa holder if your disability starts in the United States, and now you have to return to your country of citizenship because you've lost your sponsorship. If your disability started in the United States and

now you have to return, we are gonna continue to pay you with no limitation at all.

By the same token. If you were at home, let's say you were visiting a family in your country of citizenship, you left, but then you had tickets to come back to the United States within 31 days of your leaving. Guardian considers this to be incidental travel, and now if you are disabled overseas and you can't make it back.

You have proof that you left and you were returning within 31 days at the time you left. You will still continue to receive benefits overseas with no limitation. Now this holds true in all states except for California, Delaware, Florida, Montana, my home state, New York. North Dakota, South Carolina, South Dakota

and Wyoming.

So if I'm a visa holder, or I'm married to someone that's not from the United States, and if I became disabled, their whole support system is in their country of citizenship. I would wanna make sure, if at all possible, my policy would allow me to leave the United States and receive benefits. But for a Visa holder as the insured, the only company that will do this for an extended period of time is Guardian, with the exception of those states that I mentioned.

Once someone is a green card holder or they become a US citizen, then if the policy itself normally allows you to reside overseas. That's okay. But for a visa holder, this can be really, really important. It could be the difference of becoming disabled in the United States and receiving benefits outside the United States on an unlimited basis, or your benefits ending after a very limited period of time.

Typically, 12 months is the longest. Hmm. Okay, so as you said, it's as easy as 1, 2, 3. And so the first thing we have to consider, uh, one of the main things is, you know, how we wanna handle claims related to mental nervous or substance abuse. The second thing is about, uh, being, receiving benefits while overseas.

And so there, there's one more thing that varies a lot between policy to policy. Yes. So this one is if you're buying your policy and. You're a early career physician. Maybe you're a resident or fellow, or maybe you're, you know, first couple of years of practice and you know, your income is only gonna continue to go up, but your health that we don't know.

So the worst thing that can happen is your income is rising, your health is declining. You're not dead, but you're not as good as you used to be. So let's say you're an orthopedic surgeon and you developed a shoulder prop and you had one of your friends take care of you. And they did surgery.

Everything worked out great, but there's hardware in your shoulder.

Now, if you didn't have a disability insurance policy already, you would get a policy if you met the requirements otherwise. But you're also gonna get an exclusion rider stating We will not pay benefits for disease disorder treatment or complication related to your right shoulder. Well, if you bought your policy before you had the surgery and you didn't have any issues, and it's subsequently developed, if you have an increase option on your policy that allows you to buy more coverage in the future regardless of your health, as your income is rising, guess what?

Your shoulder is gonna be covered the same way as your original policy covered your shoulder. That's an ideal situation. So there's two types of increase options. I can make an argument for either one. So the first one is the one that I grew up on. This is called the Future Increase

Option Rider. We love acronyms and insurance.

It's not just for medicine, it's not just for the military. We love it also. So we're gonna use the term FIO. And really what you're doing here is you're paying for the right to be able to buy additional coverage regardless of your health, as your income is going up. And because you're paying for it, you cannot lose your option.

Every single year. It's gonna be available to you. You can choose to use it or not use it. So if you called me and you're like, my new income is X, you know the amount of insurance I already have with you, 'cause you are my agent, you know about my group insurance policy through my hospital because I've provided it to you, or you know, well, I could tell you that you're eligible for more coverage.

Great news, you have a $10,000 benefit. Currently per month. You're eligible for another $5,000 that can bring you to 15,000. This is what the

additional cost is gonna be. If you want to elect that, you could say, that's great. I was just kicking the tires. I don't wanna buy any more insurance. It's nice to know that I qualify for more.

It's nice to know what the cost is. I'm not doing anything. That's fine. Next year, you are going to get the very same notification of your increase option. We can have a very similar conversation and if you decide that you wanna buy some of that additional $5,000 benefit, none of that additional 5,000 or something in between, you can do that.

You can basically make your own decision. The negative is you have to pay for the increase option itself to have the right to be able to do it, but the positive is you can't lose your increase option, and there's really nothing that you need to do in order to keep it on your policy. Well, there's another type of increase option and principle created.

This standard insurance

company was good enough to borrow this and make it their only increase option. Then you've got MassMutual in most of the states, actually all of the states they make available both the FIO rider and what I'm gonna talk about now, the alternate increase option. Um, in some states emeritus makes both of them available.

And what you'll also find in, uh, some states, actually all of them, guardian, makes both of them available. So let's say that we were meeting really early, you were a PGY one. General surgery resident, and I'm like, Kevin, you know, you really should buy disability insurance. It's really important. Your entire financial life is gonna be dependent upon what's in your mind and your ability to perform surgery.

And you're like, Larry, it's my first year. The only thing I really need to know is like three things. Where is the cafeteria? Where is the or,

and where is the men's room? Other than that, there's really not too much that I need to know. I really am not interested in disability insurance. I get that it might be important.

I'm not there yet, and I would come back to you. I'd say, Kevin, I know you're not there yet, but I know that you've heard about disability insurance and you could buy this policy that has an increase option and pay for that. But if you're a PGY one and you're gonna be training for years, do you really wanna pay for an increase option?

You're not gonna be able to use until you're almost done with your trading at the time you have the least amount of money. Like that's probably not a great strategy. And you might say, that's probably not a great strategy. What do you have? So I would say, well, there's an alternate increase option that you can have at no cost, and it could get you to the same level or even higher than what the FIO rider will allow you to reach.

Because we're given

to you at no cost. We require that you check in with us typically every three years. And at that point we're gonna ask you who are you? Where do you work, what do you do? What have you earned so far this year? What did you earn last year? Do you have any other disability insurance besides this policy?

And we're gonna look to determine if you qualify for more coverage. If you don't, there's nothing else you need to do. You are literally only checking in to be turned down to keep your increase option alive for continued use. But if you are eligible for more coverage, at that point, you must purchase at least half of what is available.

So same example, if I tell you, Kevin, you're eligible for another 5,000. You have this increase option, which is either called the Benefit Update Rider or the bu, the Maximize your Benefit Rider or the MYB. The benefit increased rider or the

BIR, uh, you have to buy at least half. So if you don't check in, or you don't buy at least half of that 5,000, you're going to lose your increase option.

It's gonna be removed from your policy, and in many cases, you will not be able to add it back to your policy. So at that point, if you want more, you have to buy a new policy from the same company or another company and really go through the process again. To supplement it. So there's two schools of thought here.

Number one is I'd rather just pay for my increase option. I know I can't lose it. There's nothing I need to do or don't need to do to keep it on there. When I wanna buy more, I'll let you know. The other school is, I don't wanna pay for an increase option, especially if it's really early in my career and I won't be able to use it for years.

I'd rather take the money I would've spent on the increase option and use it to buy more insurance under the no cost increase option. But

again, the no cost increase option, you generally have to check in and you have to buy at least half of what you're eligible for. If you don't check in after multiple attempts or you don't buy at least half, if you are eligible, you're going to lose your increase option.

So. It really comes down to those three things. How do my claims get looked upon for mental and nervous conditions? How are my claims handled if I'm disabled and I choose to reside outside the United States or Canada? And what type of increase option do I really want? I. My policy. Does that make sense?

Yeah, no, it does. And so once you have those three, uh, pieces of information from the person you're working with, then you figure out which state they live in and all the other things. Then you figure out which company is the best fit for them. Is that how that works? Yeah, that's basically my decision tree.

And a lot of times I'm gonna provide illustrations of coverage. In advance, you know, which has the pricing based on age and gender and state of

residence and medical specialty. And then I'm gonna highlight these differences. So if you're listening to this and I sent you illustrations of coverage and you're like, I don't wanna have something where I need to buy a minimal amount of coverage, or I need to check in, well, you know, the companies that only make that available as their in pre option, you're probably not going to want.

Very easy. And then we look at everything else that we know and we navigate to price. And what am I getting in terms of cost savings if I'm opting for policy A versus policy B, or what am I getting if I'm willing to pay more in terms of policy A versus policy B? And then the other things that we wanna have in our policy is what you said, we wanna have own occupation.

That's our definition of disability. Some people will use the term own specialty. Technically own specialty is not correct because it's always based on what are you

doing and how has an accident or a sickness impacted your ability to do what you used to do. So if I'm a vascular surgeon and I can no longer perform my job duties as a vascular surgeon due to an accident or sickness.

Ideally, I want my policy to pay me my full benefit, even if I can transition into another occupation or another medical specialty, whether it's using my education, training, and experience or not. It literally is almost like a second license to work in your specialty if an accident or sickness takes that away.

Yeah. Okay. No, I, I've. Definitely. And so I could work as a, uh, you know, a va. Like in the military, we have a, all these docs that evaluate people for VA claims or something like that. Um, if I was a va Yeah. Like, or teach in a medical school or some examples. Uh, Hey Larry, before we wrap up, this first one, one thing I

always wondered when listening to these podcasts, when we put you on the, the hot seat a little bit here, give our residents.

Sort of a, a ballpark. I know it's different whether you're male or female in your specialty, but say they're looking, uh, for kind of a, a general low cost option that has some type of future rider in it. What type of of monthly fees, um, are, are, are, are people gonna be paying here? Yeah, I'm gonna say somewhere between a hundred dollars and $150 a month.

I would say the a hundred dollars would be more for your male physicians. Uh, $150 might be more for your female physicians. Uh, rates for females are higher, uh, due to pregnancy and complications of pregnancy, uh, due to a higher rate of autoimmune disorders, and believe it or not, due to a, a higher incidence of mental slash nervous and or substance abuse disorders.

Then different insurance companies will

classify different medical specialties differently. Uh, you might also find that a company like Guardian has what's called a graded premium, where it's lower in the beginning. Each year gets a little bit more expensive, but you always have the ability to switch from an annually increasing rate to a fixed rate.

And this is really where the expertise of the insurance agent comes in because we can easily modify the policy. To meet your individual needs and goals and philosophy that way, having some coverage is certainly better than having no coverage, and some companies allow you to start with a really low benefit and a really low premium and still have the ability to ramp up to as much as 20 or thou $30,000 a month.

So you really can, I call this the least, with the option to buy plan. You can do that. Also, like most important thing is we lock in the fact that you're in good health. We lock in the fact that you have your policy, and then when your

finances change, you adjust the policy accordingly. The only other things that we would look for is a partial disability benefit.

So as good as own occupation is, it's kind of like being pregnant, right? You either are or you're not. So in your case, look Kevin, you're either working as a vascular surgeon or you're not. But if your doctor says, Kevin, I gotta tell you like you don't look great, man, but you don't look horrible. You could still work as a vascular surgeon, but you have to work fewer hours per day.

You gotta work fewer days per week. You gotta do fewer cases and see fewer patients. Well, odds are pretty good. Your practice or hospital is gonna pay you less money. Own occupation doesn't do anything about less money. It only does the inability to do your job, and that's when you get paid. So this piece, the residual or partial benefit, takes away the all or nothing and introduces the loss of income component.

So if you're never totally

disabled or you were totally disabled, and now you go back to work on a limited basis, now you're gonna get benefits typically proportionate to your loss of income. We wanna have a cost of living adjustment. Rider. Again, think about the military, a cola rider, and this is gonna increase your benefit after disability has lasted for 12 months.

This is gonna help maintain your purchasing power and early on in your career, when you have a lengthy career horizon ahead of you, not a lot of money, possibly a whole lot of debt. This is really important. But as your situation changes and you get older. The number of years that you can receive benefits under your policy goes down, you might consider removing the cost of living adjustment rider from your policy.

Maybe you even consider extending the waiting period, which is kind of like your deductible of time before benefits become payable. Yeah, no, that makes a lot of sense. And um, I was just

sort of, sometimes when I was getting early with my finances, I, I looked at these, uh. Financial waterfalls for both the resident and the attending.

And, uh, really on both charts. As a resident, it says the first thing on the entire financial waterfall, even before your 401k, is to secure disability insurance. Um, and then on the attending waterfall it says to increase disability insurance. So, uh, this is from outside people. This is, uh, really thought especially, um, you know, you know, we're not getting paid till we're, uh, 35 years old sometimes.

Um, really ensuring that we're gonna have the high income that we've earned. And so this is a really important thing, uh, for people to take serious and to look into. Yeah, I mean, no one ever thinks that they're gonna be the person that's disabled. I mean, I can tell you, if I wasn't in this industry, would I be hypersensitive to this?

Absolutely not. But at the end of the day, as much as we love what we do, we're really nothing more than highly

educated, highly motivated. I. Moneymaking machines and if the machine breaks down and you insure the machine, you're going to likely be okay if the machine breaks down and you didn't insure the machine, you just ensured the stuff that you had.

Well, at that point, even the best laid financial plans might come to a screeching halt, so I could not agree with you more. I would say if you make it out of residency and you did nothing more than buy an individual disability policy. If you're married, if you have a family history, if you have someone that depends upon your income, like kids or parents, buy a term life insurance policy, maybe start your investing or get an emergency fund set up and have your employment contract reviewed before you get your first job by a qualified healthcare attorney, you've done about as well as you could do.

Absolutely. And and, sorry, one step back is.

In your personal experience, when people do go on disability, what percent of them are using it for a year, two years, three years to get back on the horse versus, you know, like, my career is over and, um, I, you know, I'm done. Yeah. I've had a mix of both of 'em. I, I think the last I checked the, the average length of a claim is about two and a half years.

I, I can tell you a bunch of, uh, surgeons that come to mind that are never going to be able to work again as a surgeon, and they're in their forties and fifties, like late forties, early fifties, some it's earlier forties. Insurance really is just about the law of large numbers. It's a lot of people paying premium.

For those that become disabled that actually need the benefits, it's nothing more than a pooling of risk and it's one of those things that you, you really have to

do to make sure that your income is covered unless you have other sources. If you say, I'm a trust fund baby, I've got plenty of money, then I would say, maybe you don't necessarily need disability insurance, but if you are working because you have to work and you need the income that's generated by your job.

I would say you probably need disability insurance and buying insurance is really one of the most efficient ways that you can do it. I mean, the other ways to do it is you know, you rely on friends and family members, or you have enough assets put aside and you have reached financial independence, and if you never work another day in your life, it doesn't matter, then you probably don't need your disability insurance anymore.

So, Larry, if people wanna use your expertise in your, I don't know, 30, 40 years in the field to find the right disability insurance policy for them, how, how do they find you? Yeah, so I'm pretty easy to find,

uh, they can email me. It's uh, l Keller, L-K-E-L-L-E-R, at Physician Financial Services, all spelled out.com.

They can always call 5 1 6 6 7 7 6 2 1 1. And I would say exactly that. Like use me as a resource. You know, I'm happy to review policies that you might be considering. I'm happy to review policies that you might already have to see if you could potentially do better. Uh, I'm happy to review policies and see if your situation has changed.

Maybe you can make some changes to your existing policy, uh, in order to provide more coverage or to better meet your individual needs, goals and philosophy. Awesome. Well, thanks Larry. And to all our listeners out there, especially the residents and fellows, make sure you tune into part two as there's been major shifts in the insurance industry that you need to hear about regarding,

uh, guaranteed standard issue plans.

And so, uh, make sure you listen for episode two with Larry Keller. Larry, thanks for joining today. Thanks so much for having me.