Physicians are buying more disability insurance policies than they did a year ago, but many of those policies offer less protection than what clinicians carried a decade ago. More physician disability insurance policies are being sold, but the overall premium behind them is shrinking, showing that physicians are gravitating toward policies with less protection. The split shows how physicians are choosing coverage structures built around slimmer benefits and adjustable features—an approach Guardian anticipated years before the current shift took hold.

This trend comes at a time when physicians face rising financial exposure. Only 43 percent of working Americans carry disability insurance, according to the Guardian Workplace Benefits Study. The gap between what physicians earn and what their disability policies actually cover keeps getting bigger. Many rely on employer plans during residency and early attending years, but those plans often cap benefits well below a physician’s income or fail to protect specialty duties, such as performing microsurgery or interpreting complex imaging studies. As incomes grow, many doctors switch to individually owned plans, but they often choose policies with smaller benefits and fewer built-in protections, adding extras only when they need them.

Industry premium data shows why. “New annualized premium for the individual disability income insurance market rose 7.8% to $444 million in 2023, the largest increase since the 2002 data,” wrote consulting actuary Tasha Khan in Milliman’s disability-income survey.

Physicians are clearly buying coverage. But the rise in policy count, combined with a decline in premium, suggests they are buying policies with smaller benefit amounts and fewer included features than in previous years. That mismatch raises questions about whether today’s disability insurance aligns with the risks physicians actually face.

Physicians play a significant role in the individual disability insurance market. They remain one of the most active groups seeking coverage because their income depends on clinical duties that can be disrupted by illness or injury. Even small changes in how insurers design coverage can affect how doctors protect their earnings.

How Guardian Anticipated the Shift Toward Leaner, More Flexible Coverage

Guardian’s 2012 redesign of its ProVider Plus line emerged during a period of dramatic change in medical practice. Hospitals were hiring more physicians, electronic health record requirements were growing, and reimbursement pressures were shrinking margins. More physicians began working directly for hospitals, carried higher student-loan balances, and relied more on employer-sponsored benefits.

Guardian rebuilt its disability insurance to reflect that shift, dividing its product into two paths: a comprehensive contract aimed at high-earning specialists and practice owners, and a streamlined contract aimed at employed physicians who needed predictable and affordable protection.

The redesigned policies emphasized flexibility over fixed benefits. Guardian strengthened own-occupation language so that physicians could collect benefits if unable to perform the duties of their specialty—even if they could work in another medical capacity. The feature gave specialists clarity about how a disability affecting precision, dexterity, or stamina would be treated. For procedural fields such as surgery, cardiology, orthopedics, and interventional radiology, this clarity remains central to how physicians evaluate disability insurance today.

Guardian also moved the market toward modular construction. Instead of offering a single, fully loaded contract, the redesign allowed physicians to build coverage over time—adding cost-of-living adjustments, student-loan repayment riders, residual disability provisions, and future increase options. 

The approach reflected real career stages: residents protecting loan payments, fellows adding modest amounts of income protection, and new attendings expanding benefits as earnings grew. Many insurers have since adopted this structure, and slimmer base contracts paired with optional riders have become a standard way physicians build their disability coverage.

One feature from the redesign proved unusually forward-looking. Guardian introduced a lump-sum disability benefit equal to 35 percent of total disability payments, payable even after a physician returned to work. The rider recognized that disability affects long-term retirement savings, not just short-term income. Today, as more physicians rely on defined-contribution retirement plans, the logic behind this design has become even more relevant.

As these features spread across the market, physician buying patterns began to reflect them. Doctors increasingly combine group coverage with individually purchased contracts that prioritize flexibility and specialty protection over maximum benefit amounts. The trend mirrors Guardian’s early prediction that physicians would build coverage in layers as their responsibilities and financial risks changed.

Physicians’ focus on contract language has amplified the importance of these design choices. Slight adjustments in own-occupation definitions, residual disability triggers, or benefit periods can change how effectively a policy protects a specialist’s income.

“Healthcare workers are exposed to a multitude of hazards in the hospital environment, increasing their risks of sustaining injuries at a higher rate compared to workers in other sectors,” Dr. Ghassan Khairallah and colleagues wrote in BMC Public Health.

As more physicians enter the market with different clinical responsibilities and changing income levels, insurers continue to revisit contract wording to manage risk—often returning to principles embedded in Guardian’s earlier redesign.

Employer-sponsored disability benefits rarely address these details. Group plans typically replace only a portion of income and may not recognize the physician’s specific clinical role. A plan that replaces 60 percent of salary does not always account for call pay, moonlighting income, or bonus structures common in many specialties. Physicians who move between institutions or split time across clinical settings face additional gaps. These realities push many doctors to purchase individual policies that travel with them, preserve specialty protection, and adapt to career changes—structures first emphasized in Guardian’s earlier redesign.

What Leaner Disability Coverage Means for Physicians Today

Even as more physicians buy disability insurance, the market shows persistent gaps in how much protection they carry. Many doctors take on modular policies with lower base benefits and add riders only when their income grows or their schedules stabilize. Others rely heavily on future-increase features to build toward stronger coverage later in their careers. These choices reflect the flexibility Guardian emphasized, but they can still leave physicians with too little income protection if a disability happens early in their careers.

High student-loan balances, variable schedules, and evolving clinical responsibilities intensify the need for reliable income protection. Riders tied to loan repayment, residual disability, and retirement savings continue to play a larger role in how individual policies are built. These additions show how physicians tailor coverage to their specific risks, but they also show how coverage can remain incomplete if not updated regularly.

Physicians who rely on non-cancelable policies remain anchored to a structure that protects definitions and benefit levels even as their careers change. These policies form the backbone of long-term financial security for many specialists. Their durability shows how much of today’s physician disability-insurance market still reflects elements Guardian sharpened more than a decade ago.

Guardian’s redesign did more than introduce new features. It established a framework that continues to influence how physicians compare policies, interpret definitions, and weigh the gap between their income and their protection. As physicians confront rising financial risk, the structure Guardian anticipated early remains central to decisions about physician disability insurance and long-term personal stability.