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Mental-Nervous Coverage & Why It’s Important

Mental-Nervous Coverage & Why It’s Important

| April 30, 2019

What is Mental/Nervous coverage, and why is it so important?

If you’ve sold any disability income insurance at all, you have probably seen or heard this term: “mental/nervous.” Group LTD policies have a 2-year limitation on these claims. Many individual policies also have a 2-year limitation. However, the Premier package in Guardians Provider Choice* contract offers full coverage for metal/nervous disabilities for most occupations.** Why is this important?

First, let's explore what is included in this category. Take a look at this book:

The DSM-5 is a clinical book used by Psychiatrists. It is a massive catalog of all the various conditions that have a psychiatric component, and it creates a common language for medical professionals to use when diagnosing these conditions.

Some of these conditions you probably know are already included in the mental/nervous category: depression, anxiety, stress, etc. Those are the most identifiable. But, did you know that these conditions are also included?

-    ADHD

-    OCD

-    Bi-Polar Disorder

-    Sleep Disorders

-    Eating Disorders

I’d encourage you to look at what is generally included in the DSM-5, so you can see a more detailed list:

When you see a 2-year limitation on mental/nervous disabilities, that limitation is intentionally broad. It is designed to be a catch-all. Its purpose is not shrouded in mystery: it is designed to LIMIT these benefits.

Are you currently selling a disability policy that only offers 2 years of mental/nervous benefits? This would include all the Northwestern Mutual agents out there. The Northwestern Mutual policy has a 2-year mental/nervous limitation per occurrence. Mass Mutual? Their Radius Choice product has the per occurrence limitation on all policies! It’s important to understand that your clients are entering into a disability contract that may only pay 2 years of benefits on these conditions.

Some things are too important to leave to chance, and mental/nervous benefits are one of them. Call an Ashford Brokerage Manager, and they will thoroughly outline for you the competitive advantages of the Guardian Premier disability product.


* Individual disability insurance policy Forms 18ID, 18UD, and 18GI underwritten and issued by Berkshire Life Insurance Company of America, Pittsfield, MA, a wholly owned stock subsidiary of The Guardian Life Insurance Company of America, New York, NY. Product provisions and availability may vary by state. In New York: These policies provide disability insurance only. They do not provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department. For policy form 18ID, the expected benefit ratio is 50%. For policy forms 18UD, 18GI, 18UD-F, an 18GI-F, the expected benefit ratio is 60%. The expected benefit ratio is the portion of future premiums that the company expects to return as benefits, when averaged over all people with these policy forms.

** All new policies issued to anesthesiologists/anesthetists, emergency room physicians, dentists, and pain management physicians, as well as all policies issued in California, will have a 24-month Mental and/or Substance-Related Disorder (MSRD) limitation. No MRSD limitation will be applied to policies issued as the result of a future increase or purchase option when exercised from a policy that did not have such a limitation.  Discounts are applied when there is an MSRD limitation.