Incentive Gap

In the context of disability insurance, the "Incentive Gap" refers to the intentionally designed difference between an insured person's pre-disability income and the actual disability benefits they are eligible to receive. This gap is created by insurance carriers to provide a financial incentive for the insured person to rehabilitate and return to work.

Key aspects of the incentive gap include:

Design Intent: Insurance companies deliberately insure only a portion of an individual’s pre-disability income (e.g. to a maximum of 70%). This ensures that the benefits received during disability are less than the pre-disability income.

Benefit Ratio: The percentage of pre-disability income covered by insurance typically decreases as income levels increase.

Alignment of Incentives:

• For the Insured: The gap encourages the insured to return to work as soon as possible, as full employment offers better financial rewards compared to remaining on disability benefits.
• For the Insurer: It helps insurance companies minimize the duration and total amount of benefit payouts.

Health and Rehabilitation: The incentive gap supports quicker recovery and better rehabilitation outcomes by motivating the insured to pursue treatment and return to their normal activities and employment.

By understanding and managing the incentive gap, insurers aim to maintain aligned incentives that are beneficial for both the insured, in terms of health and financial stability, and the insurer, in terms of reducing long-term benefit costs.