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STD Premium vs. Benefit Amount

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NancyNancy

Junior Member
What is the name of your state? Pennsylvania

Husband "bulged" 3 disks and has been out of work since October. We paid extra for additional disability insurance that we THOUGHT was his annual income amount. Well, it seems that the insurance company feels he "doesn't qualify" for that amount as he is a salaried manager, but much of the salary is bonuses/commissions and based on profits.

His weekly salary amount without bonus (the majority of his income is bonus) is more than what the insurance company is willing to pay...they feel he is "worth" about half of what he was on track to earn this year. And then they are basing their "formula" on only 10 months of income and NOT 12 months. Last year he was NOT a manager and made much less income, plus he was only with this company for 3 months in 2003. The insurance company said they are using 2003 figures, which is WRONG since he has a new title and income.

Now, the clincher...we just found out today that what we thought we were paying for in the additional disability insurance is NOT what we are getting. For example, if the additional insurance costs $15 per month for X amount of coverage (annual salary), yet the actual amount of benefit the insurance is saying we qualify for would have only cost $8 per month, why were we charged the difference? And why is the company (employer or insurance) benefitting and receiving interest off of OUR money? Because I made a fuss today, I was told I WOULD get a refund. Then I asked HOW would we have known that we were overpaying for insurance if we did not file a claim and was told that we wouldn't have known!!! So how many people out there are overpaying for insurance and don't know it and the company is keeping the money????

Another "tiny" thing is that neither the employer nor the insurance company will give us a copy of the policy, guidelines, formula, or any other info regarding what the terms are! They say we were mailed a copy, but I don't have one. When I ask the insurance company they say I have to get it from the employer and their agent. When I ask the employer, I am told they don't have it and it should come from the insurance company! So I am getting the run-around and I don't like it! And we have no idea what the "rules" are here.

When we filled out the paperwork for the disability, you put how much additional insurance you want, or the max, and benefits/HR does the rest. We never see that form again or know exactly what we are getting for our money! Plus HR says they don't know what each employee is getting should they file a claim as it is individualized! Seems there should an across-the-board formula.

As I am writing this it sounds more and more like I need a lawyer! But I am basically looking for information first and how this REALLY and LEGALLY works!
 


Disability Wiz

Junior Member
Not sure I understand all the details of your husbands claims, but disability insurance is usually based on salary he was earning at the time of disability. Also, most plans do not cover bonuses, overtime, etc. only straight salary. Benefits are usually anywhere from 35%-70% depending on plan.

I would put ALL your requests in writing and direct them to the Supervisor, then Manager, then VP of the insurance company.
 

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