Individual Death ClaimsThe most important and basic feature of insurance is the protection provided. The prompt consideration and payment of claims is the most vital service we can offer our policyowners. The claims handled in the Claims Administration Department are:
Individual Death Claims
Individual Waiver of Premium Claims
Individual Disability Claims
Accelerated Death Benefit Rider Claims
To assist the Claims Administration Department in providing the best service possible, claim forms should be fully completed and accurate, including proper signatures.
The Home Office has assembled a Death Benefit Claim Form (Form CL 70.383) which collects the information necessary to file a claim.
1. Death Benefit Claim Form, Form CL 70.383, fully completed and signed by each beneficiary.
2. Certified death certificate listing the cause and manner of death of the Insured.
3. Some circumstances may require additional information; refer to guidelines for assistance.
1. Letter to beneficiary or party requested by beneficiary to handle claim (indicate if proceeds are to be returned to agent).
2. Benefit check, unless other form of settlement was selected by policyowner or beneficiary.
3. Email Notification with message: DEATH CLAIM PENDING (upon notice of death).
4. Email Notification with message: DEATH CLAIM SETTLED (upon settlement of claim).
1. Multiple beneficiaries should complete separate claim forms.
2. If the contract/policy was assigned, a release of assignment or a written statement of the Assignee's interest signed by two officers is needed from the assignee before the claim can be settled.
3. If the beneficiary predeceases the Insured, a copy of deceased beneficiary's death certificate is required.
4. If proceeds are payable to the Insured's estate, a copy of the letters of appointment naming the executor/administrator of the estate is required.
5. If proceeds are payable to a Trust, a copy of the Trust Agreement is required. Verification of Trust Death Claim Form (Form CL 70.374) is also required.
6. If proceeds are payable to a Testamentary trust, a certified copy of the instrument issued by the court that evidences appointment of the Testamentary Trustee.
7. If the beneficiary is a minor, a copy of the court appointed guardianship papers for the minor’s estate is required. (Payment will be made to the appointed guardian.) NOTE: most states offer transfer to a guardian for the benefit of a minor up to a specific dollar amount under UTMA/UGMA.
8. If the policy contains an Accidental Death Benefit and death was due to an accident, Questionnaire for Accidental Death Claims Form (Form # CL.70.389) will be requested along with news articles, accident reports, and any other documentation that will help expedite the claim.
9. If a death benefit claim occurs during the first two policy years, the claim is considered contestable and a routine contestable review will be completed. The benefiicary will be required to complete a A Word About Contestable Claims Form (Form CL 70.279); which also includes helpful information in regard to contestable claims. We will also require the Producer to complete the Agent Statement Form (Form CL70.371).
Disability Claim Form (Form CL 70.177) to be completed in full by both Insured and physician. HIPAA Authorization Form (Form CL 45.406) is to be completed by the Insured. This form is state specific.
1. Letter explaining decision on claim.
2. Refund check for premiums paid while disabled, if applicable for traditional policies.
1. For proper completion of claim form:
a. Insured should complete pages 1-5.
b. Physician should complete pages 6-9.
2. To avoid any delay in processing, the HIPAA Information Form (Form CL 45.406) should be completed, signed, and dated by the Insured. Please note there may be state specific variation to this form.
3. The Home Office should be notified of disability when the claimant has reached the end of the elimination period as stated in their contract.
4. If disability commenced more than one year before notification is received by the Home Office, premiums will be refunded and/or deductions will be credited for only one year.
5. Home Office should be notified as soon as possible when claimant returns to work.
Disability Claim Form (Form CL 70.177) to be completed in full by both Insured and physician. HIPAA Authorization Form (Form CL 45.406) is to be completed by the Insured. This form is State specific.
1. Disability Income benefit check.
2. Explanation of Benefits sheet.
3. Supplementary Report Form (Form CL 80.119) to be completed by both the Insured and physician for continuation of benefits. (Not required if not included with check.)
4. Letter explaining decision if claim is denied or delayed for additional information.
1. For proper completion of claim form:
a. Insured should complete pages 1-5.
b. Physician should complete pages 6-9.
2. To avoid any delay in processing, the HIPAA Authorization Form (Form CL 45.406) should be completed, signed, and dated by the Insured. Please note there may be state specific variation to this form.
3. The Home Office should be notified as soon as the elimination period is over, provided disability is continuing.
4. Any information in addition to what is covered on claim form, which may affect handling of claim, should be supplied in accompanying correspondence.
5. Home Office should be notified as soon as possible when claimant returns to work.
Accelerated Death Benefit Claimants Statement (varying form #’s based on product) completed by the Insured, Owner (if other than the Insured), assignee, and any irrevocable beneficiary
Accelerated Death Benefit Claim – Physicians Statement (varying form #’s based on product) completed by the attending physician.
HIPAA Authorization Form completed by the Insured.
1. Benefit check
2. Letter of explanation
3. Payment Notice
Please contact the Claim Department for instructions regarding the required forms.