Claims CCC (1)
What is a High Review?
A High Review is a simplified claim review used when the beneficiary is clear and the death benefit amount is minimal.
Where is the death benefit amount found in a claim?
In a screen print of the U107 screen in AWD. under quote
Waiver of Premium
What does it do?
Covers premiums if the insured is disabled.
Where should all claim-related comments be recorded?
In the Claims Notes transaction
What is the abbreviation for the Critical Illness Rider?
CRI.
What is a rescission?
It is when a policy is canceled due to misrepresentation or missing information that would have prevented issuance.
What does a Secret folder indicate?
A sensitive case, such as litigation—calls must be transferred to the examiner.
Settlement Options
What is Option A?
A lump sum payment, usually by check.
Who receives the claim packet?
The listed primary beneficiary.
What are accelerated benefits?
Accelerated benefits are living benefits that allow a policyholder to access part of their death benefit while still alive.
What does it mean to disclaim a death benefit?
It means the beneficiary formally gives up their right to the benefit.
Does ENCORR always mean claim packet?
No, it can include any outgoing letter.
Unemployment Benefit Rider.
What is the waiting period?
90 days.
Claims Case Tagline
What does “MULT = Y” mean?
There are multiple policies for the insured.
What is the elimination period for Waiver of Premium?
Usually 6 months (must verify in policy).
How is a High Review identified in AWD?
The case will have a tagline showing “High Review.”
What is the most important transaction to review for claim status?
Claims Notes.
Terminal Illness
What qualifies for this benefit?
A diagnosis with a life expectancy of typically 12 months or less.
Claims Case Tagline
What does “CONT = Y/N” indicate?
Whether the claim is contestable.
Terminal Illness Rider
What happens if the full death benefit is requested?
The policy remains active during processing and is marked as surrendered after completion
How is LTC benefit paid?
Monthly payments
What does the claim total include in AWD
Loan payoff, premiums, and interest adjustments
Critical Illness
Name the qualifying conditions.
Heart attack, stroke, cancer, renal failure, ALS, organ transplant.
Can information be released to a terminated agent? if no,what is the only possible way to release information to a terminated agent
No, unless the beneficiary provides permission.
Long Term Care Rider (LTC)
What must be true for eligibility, what allows the insured to qualify?
The insured must be chronically ill and meet the 90-day elimination period.