AMNY first reported on January 8, 2026, that New York Police Department officers fired on a man barricaded with a knife inside a patient room at NewYork-Presbyterian Brooklyn Methodist Hospital, with hospital staff observing blood on the door and walls before officers entered.
Most disability insurance policies treat assault-caused disability the same as any other claim, with the same 90-day elimination period before benefits begin to accrue.
The Guardian Provider Choice contract sold to NYP residents during training includes a separate endorsement that waives the elimination period entirely when the disability results from an intentional violent act, in three sentences that most residents have never read.
The endorsement is short. It sits inside the GSI disability insurance for NewYork-Presbyterian residency programs offered through the hospital’s Graduate Medical Education contract.
What the endorsement triggers depends on the same income figures every resident calibrates at enrollment.
The endorsement sits within the broader guaranteed standard issue disability insurance programs Set for Life Insurance offers to medical residents and fellows nationwide.
“If you become Disabled as the result of an Act of Violence, We will waive the unexpired portion of the Elimination Period and benefits will start to accrue from the date of Your Disability. Act of Violence means an intentional violent act committed by another person, against you, that involves force resulting in Your Injury or Sickness. The Act of Violence must occur on or after the Effective Date of the policy.”
Waiver of Elimination Period for Act of Violence Endorsement, Form ICC23 VTPC, attached to Guardian Provider Choice Policy Form ICC16 18ID, Berkshire Life Insurance Company of America
The first sentence does the structural work. A standard total disability claim under the base policy requires the insured to satisfy the Elimination Period, typically 90 days, before benefits begin. For a NewYork-Presbyterian resident who is assaulted on shift and disabled by the assault, that 90-day waiting period eliminates roughly a quarter of a PGY-1 year of income before the policy pays anything. That figure runs against the cost of living analysis for NewYork-Presbyterian residents that determines how far each month of replaced income actually goes. The endorsement removes the wait. Benefits accrue from the day the disability begins.
The second sentence defines what counts. Four filters apply. The act must be intentional, eliminating accidental harm. The act must be committed by another person, eliminating self-inflicted injury. The act must be directed at the insured, eliminating bystander injury. The act must involve force resulting in Injury or Sickness, with the inclusion of “Sickness” doing more work than the term suggests. Sickness in the base policy includes psychological and psychiatric conditions defined under the Diagnostic and Statistical Manual of Mental Disorders. Post-traumatic stress, acute stress disorder, and major depressive disorder following an assault qualify under the endorsement on the same footing as a fractured wrist or a concussion.
The third sentence is a temporal limit. The act must occur on or after the policy’s Effective Date. A resident who experienced a violent assault before the policy issued cannot retroactively claim under the endorsement.
Act of Violence Endorsement Pairs With Presumptive Total Disability
The endorsement does not stand alone. The Provider Choice contract also includes a Presumptive Total Disability provision that triggers separately for the catastrophic outcomes that workplace violence sometimes produces.
“We will consider You to be Totally Disabled even if You are Gainfully Employed if, while the Policy is in force, Injury or Sickness results in Your total and complete loss of: sight in both eyes; hearing in both ears; speech; or the use, in their entirety, of both hands, both feet, or one hand and one foot. We will then waive the unexpired portion of the Elimination Period and benefits will start to accrue from the date of Your Total Disability.”
Presumptive Total Disability Benefit, Provisions Relating to Benefits, Guardian Provider Choice Policy Form ICC16 18ID, Berkshire Life Insurance Company of America
Presumptive Total Disability operates by automatic determination. The base policy ordinarily requires the insured to be unable to perform the material and substantial duties of the occupation. The Presumptive provision sets that test aside for specific catastrophic injuries. A resident who loses the use of both hands as the result of a violent assault is treated as totally disabled by the policy, with benefits accruing from the date of the disability, regardless of whether the resident could perform some other gainful work. The Presumptive clause and the Act of Violence endorsement work in parallel for assault outcomes that fall inside the Presumptive list.
“There really is no logical incompatibility between being totally disabled and working full time. It is general human nature that people will struggle to work as long as they can, and when they reach the point where they can’t anymore, instead of punishing them, they should be rewarded for their courage and heroism in persisting as long as they did.”
Mark D. DeBofsky, a shareholder at DeBofsky Law, Ltd. and an ERISA litigation attorney with more than four decades of experience challenging insurer benefit denials, on the Income Protection Journal Podcast
For a NewYork-Presbyterian-trained physician assaulted on shift and rendered unable to use one hand, two policy provisions trigger simultaneously. The Act of Violence endorsement waives the elimination period because the disability resulted from an intentional violent act. The Presumptive Total Disability provision treats the loss of hand use as a presumptive total disability, also waiving the elimination period and locking in benefits for the duration of the policy’s Benefit Period.
Workplace Violence Data at NewYork-Presbyterian Makes the Disability Provision Material
The exposure profile at NewYork-Presbyterian is documented across multiple authoritative sources. The Bureau of Labor Statistics reports 41,960 nonfatal workplace violence cases in healthcare and social assistance over 2021 to 2022, representing 72.8 percent of all private-industry workplace violence cases nationally. A 2016 peer-reviewed study by Schnapp et al. surveyed emergency medicine residents across three New York City residency programs and found that 65.5 percent had experienced physical violence from a patient during training. A 2024 American College of Emergency Physicians member survey found that 40 percent of respondents knew of a healthcare worker attack at a trauma center resulting in moderate-to-severe disability or death.
The 2026 New York State Attorney General settlement with NewYork-Presbyterian over systemic mental health emergency care failures documented the upstream institutional conditions under which assault risk concentrates. The settlement named gaps in screening, supervision, and elopement prevention as findings, with NYP required to restore 100-plus psychiatric beds and pay $500,000 in initial penalties, with additional $10,000-per-violation penalties for future failures.
NewYork-Presbyterian’s own published response architecture acknowledges the same exposure. Behavioral Emergency Response Team protocols, electronic medical record flagging for patients with violent histories, de-escalation training, and Department of Homeland Security Targeted Violence and Terrorism Prevention grant-funded threat assessment training appear on the system’s public safety pages. The institutional response exists because the exposure is real. The Act of Violence endorsement in a NewYork-Presbyterian resident’s individual disability policy is the income-side response to the same exposure, in the moments when institutional controls do not prevent an incident.