THE ESSENCE OF BEING A DOCTOR HAS CHANGED

Disability coverage ... is going through some rehabilitation of its own these days.

... the changes are being prompted by a record number of claims from physicians, among the biggest buyers of individual disability insurance. The surge, which partly reflects declining job satisfaction among doctors, is resulting in deteriorating profits—and, in some cases, losses—for insurers. Many now are moving toward a major overhaul of such coverage.

Individual disability insurance, which generates $3 billion a year in premiums for the insurance industry, provides replacement income for people unable to work as a result of accident on illness. The length of coverage under the policy can range from short-term to indefinitely. Many companies provide their workers with some type of disability insurance, but self-employed people, primarily doctors and lawyers, have to buy their own coverage.

Doctors have long been among the most favored customers of disability insurers because their job satisfaction generally translated into short absences from work as a result of accident or illness. Insurers viewed them as extraordinarily profitable bets for replacement-income insurance.

But lately, many doctors, especially specialists, have lost enthusiasm for their work, according to insurers and industry analysts. A big reason, they say, is that managed-care organizations, concerned with controlling costs, monitor doctors more closely and squeeze their incomes.

"There's no question oven the last year and a half the essence of being a doctor has changed," says Elaine Rosen, a senior vice president at Unum. The job isn't as entrepreneurial as it used to be. "It's a phenomenon in the world of disability-income insurance that people will tough it out and go to work everyday if they are satisfied and motivated, but if satisfaction starts to "dwindle" they're more inclined to opt for the disability rolls," she says.