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Need to process a claim?

If you need to file a claim, your first step should be to review your policy documents for the specific claims procedures, required documentation, and applicable deadlines. Depending on the policy and insurance carrier, you may be required to provide written notice of the claim within a specified period and submit completed claim forms and proof of loss within additional timeframes. Claim requirements and deadlines vary by product, policy, and insurance carrier, so please refer to your policy documents for the exact instructions applicable to your coverage.

Frequently asked questions:

Begin by reviewing your policy documents for specific claim procedures, required documentation, and applicable deadlines. Notify your insurance carrier of the claim as soon as possible following the covered event and within the timeframe specified in your policy. Some policies may require written notice within 30 days; however, requirements may vary by product and insurance carrier.

The timing of a claim payment depends on the type and complexity of the loss, as well as the policy and insurance carrier. Once all required documentation has been received, reviewed, and the claim has been approved, payment may be issued within approximately 14 days. Actual processing and payment times may vary.

Required documentation will vary depending on the type of claim, policy, and insurance carrier. For example, a death claim will generally require a completed claim form and certified death certificate. Additional documentation may be requested by the insurance carrier to review and process the claim.

In certain circumstances, claim payments may be made to an overseas or offshore account. This is subject to the insurance carrier’s requirements, applicable laws and regulations, policy terms, and the jurisdiction in which the policy was issued. Additional documentation or verification may be required before an international payment can be processed.
Claims

Conditions & General terms

The following provides a general overview of common claim conditions and requirements. Specific terms, deadlines, and requirements may vary by policy and insurance carrier. Always refer to your policy documents for the provisions applicable to your coverage.

Assignment of Policy or Benefits

An assignment of the policy or any benefits payable under the policy may be recognized only when the insurance carrier receives written notice of the assignment before claim benefits are paid. The carrier may not be responsible for determining the validity or legal effectiveness of an assignment.

Change in Occupation

Certain policies require the insured to notify the insurance carrier of a change in occupation, typically within a specified period such as 30 days. A change in occupation may affect the terms, conditions, premium, or benefits of the policy. Failure to provide required notification may result in a reduction of benefits, particularly when a claim arises from the insured’s new occupation.

Notice of Claim

Written notice of a claim should be provided to the insurance carrier as soon as reasonably possible following an accident or event that may result in a covered loss. Some policies require notification within 30 days. The notice should include sufficient information to identify the insured and provide a brief description of the event.

Proof of Loss

After receiving notice of a claim, the insurance carrier may provide the appropriate claim and proof-of-loss forms. These forms, together with any required supporting documentation, must be completed and submitted within the timeframe specified in the policy. Some policies may require proof of loss within 60 days of the covered event.

Medical or Professional Examination

As part of the claim review process, the insurance carrier may have the right, at its own expense, to request that the insured be examined by a physician, vocational expert, or other appropriate professional. Such examinations may be requested when reasonably necessary to evaluate the claim. In the event of death, the carrier may also have certain examination or autopsy rights were permitted by applicable law.

Important: This information is provided for general guidance only and does not amend, replace, or supersede the terms and conditions of any insurance policy. In the event of any difference between this information and the policy, the terms and conditions of the issued policy will govern.

When a Claim May Be Denied

Subject to the terms and conditions of your policy and applicable law, the insurance carrier may deny or limit payment of a claim under certain circumstances, including:

False Statements or Material Omissions

If your insurance application contains a false statement, misrepresentation, or material omission that would have affected the carrier’s decision to issue the policy, determine the premium, or establish the terms and conditions of coverage.

Fraud or Misrepresentation in a Claim

A claim may be denied if it involves fraud, intentional misrepresentation, concealment of material information, or a criminal act by the policyholder, insured person, beneficiary, or other party involved in the claim.

Important: Claim decisions are subject to the specific terms, conditions, exclusions, and provisions of the issued policy, as well as applicable laws and regulations. Please refer to your policy documents for complete details.