Legal Question in Insurance Law in New York

How do disability insurance companies calculate what to pay for a lump sum settlement


Asked on 8/20/09, 1:15 am

1 Answer from Attorneys

John W. DeHaan DeHaanBusse LLP

The answer to this question is: it depends.

If you have your own individual disability insurance policy, then the insurance carrier decides how much of a monthly benefit it will provide to you during the underwriting process -- i.e., when you apply for the policy. Basically, carriers will sell you insurance up to about 60% to 70% of your income at the time you apply for the policy, but each company has its own underwriting guidelines so the actual amount could vary.

If your disability insurance is through your employer's long term disability plan, then those plans typically provide a benefit of 50% to 70% (60% and 66.667% being the most common) of your pre-disability income. From this amount, the insurance company then subtracts the benefit amounts you receive from other sources -- e.g., Social Security disability, Workers' Compensation, disability pension, etc. Of course, all of this depends on the exact terms of your employer's disability plan.

If you are asking about New York's statutory short-term disability benefits, those are equal to 50% of your pre-disability income, but the benefit is capped at $170/week. You only get 26 weeks of benefits.

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Answered on 8/26/09, 5:14 pm


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