Can I include trigger provisions for major medical diagnoses?

The question of whether to include trigger provisions based on major medical diagnoses within a trust is a complex one, demanding careful consideration of legal and practical implications; while seemingly proactive, these provisions introduce a unique set of challenges for estate planning attorneys like myself here in San Diego, and require nuanced drafting to ensure enforceability and avoid unintended consequences.

What are the benefits of proactive estate planning?

Proactive estate planning, beyond simply designating beneficiaries, can provide significant peace of mind and financial security; approximately 60% of Americans do not have a basic will, leaving their assets subject to state intestacy laws and potential family disputes. Including “trigger” provisions – clauses that initiate certain actions within a trust upon the occurrence of a specific event, like a major medical diagnosis – allows for a more responsive and tailored distribution of assets. For example, a trust could be designed to provide additional funds for care or to shift control to a designated healthcare trustee if the grantor is diagnosed with a debilitating condition like Alzheimer’s or late-stage cancer; this type of planning isn’t merely about money, it’s about ensuring wishes are respected and burdens on loved ones are minimized during incredibly difficult times.

How do medical diagnoses complicate trust provisions?

The primary legal hurdle lies in the potential for violating the rule against perpetuities, which limits the duration a trust can remain in effect; many states, including California, have modified this rule, but it remains a consideration. More critically, tying trust distributions to a medical diagnosis can create issues of undue influence or coercion if the diagnosis is perceived as subjective or open to interpretation; imagine a scenario where a beneficiary disputes the diagnosis, claiming it was improperly obtained or misrepresented. This could lead to costly litigation and potentially invalidate the provision. Furthermore, privacy concerns are paramount; a healthcare provider may be reluctant to disclose a diagnosis to a trustee without proper authorization, and a trustee must be careful not to violate HIPAA regulations.

“Effective estate planning anticipates not just wealth transfer but also the potential for unforeseen health challenges.”

What happened when planning failed?

I once represented a client, Mr. Abernathy, a successful retired engineer, who insisted on a provision in his trust that would drastically alter the distribution of assets should his daughter be diagnosed with a specific genetic condition. He was deeply worried about her ability to manage finances if the condition manifested, but we pushed back on tying it *directly* to a diagnosis due to enforceability concerns. He ultimately prevailed, and the provision was drafted in a manner that, in hindsight, was deeply flawed. Years later, his daughter received a preliminary diagnosis, and a fierce legal battle erupted. The diagnosis was challenged, experts clashed, and the trust became mired in litigation, ultimately depleting a significant portion of the assets intended for her benefit. The family was devastated, and the entire process took years to resolve.

How can you establish a solid plan and avoid mistakes?

Thankfully, we’ve learned from such experiences. Recently, I worked with Mrs. Chen, who expressed similar concerns about her son’s potential health challenges. Instead of a direct “diagnosis” trigger, we drafted a provision that activated upon a determination of *functional incapacity*. We appointed a qualified physician, agreed upon by both Mrs. Chen and her son, to assess his ability to manage his affairs. The provision stipulated that if the physician determined he was unable to do so, a designated co-trustee would step in to assist with financial management, and resources would be allocated accordingly. This approach sidestepped the legal pitfalls of a diagnosis-based trigger and prioritized her son’s well-being. This isn’t about predicting the future, it’s about creating a framework for responsible stewardship, and a plan to meet whatever life throws your way; roughly 75% of long-term care expenses are paid for by individuals or their families, highlighting the importance of proactive planning.


Who Is Ted Cook at Point Loma Estate Planning Law, APC.:

Point Loma Estate Planning Law, APC.

2305 Historic Decatur Rd Suite 100, San Diego CA. 92106

(619) 550-7437

Map To Point Loma Estate Planning Law, APC, a living trust lawyer: https://maps.app.goo.gl/JiHkjNg9VFGA44tf9


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