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What are the side effects of switching insurers?

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What are the side effects of switching insurers?
Sylvi Karr, Sr. Director
3/13/2019
All of us like to be offered choices. After all, it’s human nature to explore options. When it comes to the issue of insurance for physicians, it’s important not to rush to conclusions. Double-checking coverage, exclusions, costs and benefits is the only way to ensure that apples are being compared to apples. Of course, that can be a daunting task.

​This is when OMA Insurance Advisors can be a valuable resource. Your Advisor knows your current policies inside out, as well as your claim history, and probably has an accurate perspective on your practice and coverage requirements. So if you’re considering another insurance option, now is a perfect time to enlist your Advisor to do the digging for you. As all medical professionals know, time is a limited commodity, dramatically so at times. Rather than taking shortcuts because you don’t have extra hours at the end of a busy day, count on your Advisor to make sure all questions are answered to your complete satisfaction. 

​  Rather than taking shortcuts because you don’t have extra hours at the end of a busy day, count on your Advisor to make sure all questions are answered to your complete satisfaction.


One can’t be faulted for wondering just how objective your current Advisor can be about a competitor’s insurance products. However, the facts are the facts, the dollars are the dollars, and the coverage in all policies is spelled out in legally unambiguous language. It’s largely a matter of knowing where to look, what to consider and how to assess the differences, major or subtle. So unless you are planning to take a well-deserved vacation and curl up by the fire with a glass of wine and a stack of insurance documents, you may want to consider enlisting the talents of your insurance Advisor.

Again, considering human nature and the relatively new adage that “Change is good,” some doctors may instinctively want to switch now and assess the results later. This runs counter to the fact that in their practice, most medical professionals tend to make evidence-based decisions regarding innovations in treatment. Veering off a tried-and-true course raises the potential for unpredictable consequences which, in this instance, could be considered the “side effects” of switching insurers.

Side effect 1: Insomnia when second-guessing coverage

What is the primary reason to trust the assessment of OMA’s insurance Advisors? Quite simply, they do not receive any commission. Their motivation is to do an excellent job of providing the coverage you need, not upselling or steering you toward products to selfishly increase their own reward. This objectivity, combined with their in-depth knowledge of the needs of physicians, is what steers their every recommendation and decision.

Also not to be overlooked is the OMA’s impressive history of insurance coverage, going back to its origins in 1956. Since that time, countless thousands of doctors have had their claims promptly settled by a team that advocates for doctors’ best interests. This team is not beholden to any insurance company nor to any profit motivation. It operates solely on the behalf of our physician members, whether at the dawn of their careers, as committed (both attitudinally and financially) medical students, or at every other stage of life, including retirement.    

​ Also not to be overlooked is the OMA’s impressive history of insurance coverage, going back to its origins in 1956. Since that time, countless thousands of doctors have had their claims promptly settled by a team that advocates for doctors’ best interests.

The not-so-simple fact is that a medical professional’s life is far more complex than the average person’s. And this is reflected in their insurance requirements. There are many more facets to consider, from legal challenges to the practicalities of operating a clinic to addressing the needs of family members while living a generally more comfortable lifestyle. It’s your Advisor’s responsibility to navigate through the options and identify the best products to address your specific needs at specific points in time. This takes both experience and expertise because, while there are many elements unique to your profession, no two doctors are in the exact same life scenario. 

This is no place for cookie-cutter solutions that could be applied to the more general public. Every product we offer, from Heath and Dental Insurance to Critical Illness to the especially important Disability Insurance, is designed with medical professionals’ needs in mind.

For many doctors, even Travel Insurance is no minor detail. Being unusually cognizant of the state of medical facilities and practices in other parts of the world certainly makes one more vigilant about coverage details. 

While most conversations with Advisors are as varied and specific as each individual doctor, there is one subject of common interest: the Premium Refund on the OMA Disability Plan. For decades, members have received a refund each year as a result of a surplus in the fund, a reflection that fellow members have experienced fewer career-threatening events than forecast.

In 2018, unfortunately for a number of affected physicians, this trend reversed. Due to the number of individuals whose careers were negatively affected by a disability, the plan had an unprecedented rise in claims, an alarming 48% increase over 2017. Therefore, for the very first time, no Premium Refund was paid on the disability product. While this was unfortunate for everyone involved, the priority and fundamental function of the disability plan is to provide the coverage necessary to help the affected doctors. As the steward of your insurance plan, OMA Insurance is committed to striking a balance between ensuring there are sufficient funds to pay claims and providing coverage at a reasonable price. Some competitors have incorrectly labelled this irregular year as an indication that the Premium Refund Program has been terminated. In fact, for the 2017/2018 plan year over $21 million was returned to members under the Life and Professional Overhead Expense coverage. The program continues, our policyholders’ disability coverage continues and, going forward, premiums not used to pay claims and expenses will be returned to members. This is just one of the numerous advantages of insurance operated on a not-for-profit basis.

Side effect 2: Possible swelling of premiums after initial offer

What steps should be taken when contemplating alternative insurance? Of course, the most important consideration is what’s best for you, personally and professionally, in terms of cost, coverage, and confidence in the organization. If any one of these three is compromised, changing insurers could turn out to be a step backwards.

While you can certainly rely on your current Advisor to help crunch the numbers and cross-reference the details, there are some factors that deserve additional thought. Health insurance premiums are substantially determined by age and health. So switching from a long-established policy may mean paying more for virtually the same coverage. Also it is absolutely vital that you fully disclose any pre-existing or ongoing health conditions or treatments you are undergoing or have been advised to undergo. Failure to disclose these issues could result in your entire coverage being voided.

As with all things related to insurance, the details determine the outcome. For most people, insurance is viewed as a necessary expense up until the time that events lead to a claim. Then, suddenly, this invisible expense takes on a different perspective: a crucial investment that either performs as hoped or does not. All of which is to say that starting from scratch with a new insurer – if you determine this to be the right course of action for you – must be done with a commitment to clarity and utmost accuracy.

Side effect 3: Difficulty swallowing excuses for claims denied

Before cancelling your existing insurance coverage, it’s wise to do a side-by-side comparison with any new replacement policy. In particular, ensure that you are aware of all new exclusions, restrictions, deductibles and limitations (especially on pre-existing conditions).

Of course, your OMA Insurance Advisor is always available to help you pinpoint any discrepancies. Naturally, they would prefer that you continue with your existing plan—there’s less paperwork. Nonetheless, you can be sure that you’ll get an honest, thorough and comprehensive perspective on all your insurance needs: a perspective that’s not influenced by profits or commissions.

That same not-for-profit stance, so fundamental to OMA Insurance, drives every decision made when we design insurance products specifically for doctors and, importantly, when we represent you should you ever have to make a claim. As part of your Association, OMA Insurance can be trusted to work on behalf of all our members every single day. But this becomes especially relevant when you actually make a claim.  That’s when we advocate for you with the insurance providers to settle your claim quickly, fairly and to your satisfaction.

Of all the services provided by OMA Insurance, what truly stands out is this ability to serve your best interests at the time you need it most. It makes us entirely unique in this field: an exception in these interesting times.