AD&D
ADB
Life Status Calls
Value Added Services
Misc.
100

What does AD+D stand for? 

Accidental Death and Dismemberment

100

What is the average time to process an ADB claim?

2 Business days

100

At what point in the call should you offer Condolences?

At whatever point in the call is most comfortable for you

100

Define EAP.

  • Employee Assistance program provides short-term counseling for issues such as relationships, workplace challenges, grief and loss, parenting, and many other concerns. (Assessment and referral for longer-term support) at no cost to employees or their household members
100

In what states are we required to perform an ICPIP search?



  • Required for beneficiaries whose residence state is MA or TX
200

Explain AD&D

  • Life coverage in addition to Basic and Supplemental
  • Only applicable if the Manner of Death is Accidental
200

What does ADB stand for?

Accelerated Death Benefit

200

When can you say a claim is payable/paid?

Only once the claim has been paid

200

Name Five Ways we can help member with our Care Model.

  • Health Benefits
  • Federal Benefits
  • Community Resources
  • Life and Disability
  • ADB and Premium Waiver
200

What is OFAC?

Office of Foreign Asset Control – Terrorist/Terrorism Check

300

Explain the Seatbelt Additional AD&D benefit.

  • Seatbelt(s):
  • Additional 10% of the Principal Sum not to exceed $10,000
  • An additional benefit will be paid if:
  • the private passenger car is equipped with seatbelt(s);
  • the seatbelt(s) were in actual use and properly fastened at the time of the covered accident; and the position of the seatbelt(s) are certified in the official report of the covered accident, or by the investigating officer. A copy of the police accident report must be submitted with the claim.
300

Do ADB claims impact SSD, STD or LTD eligibility or payments?

No

300

To whom can you provide benefit amounts paid?

Only to the beneficiary paid or Employer/HR

300

What are 6 examples of things you may hear a caller say that would trigger a Social Worker/Zurich Cares Referral?

  • I can't afford to pay for my medications
  • I don’t have enough money to pay for my medical forms to be completed
  • I'm behind on my utilities and they're going to turn off my electricity tomorrow
  • I'm behind on my mortgage/rent
  • I'm having difficulty getting to medical appointments, work or the store
  • I need caregiver assistance
300

What is the healing book? Is there a cost?

  • Helps children ages 4-13 deal with the death of a loved one
  • Children complete activities with an adult to help them process their grief
  • This is offered free of charge on all claims for children, grandchildren, siblings of the deceased.
400

Explain the Airbag Additional AD&D benefit.

  • Additional 5% of the Principal Sum not to exceed $5,000
  • An additional benefit will be paid if:
  • the private passenger car is equipped with an airbag for the seat in which you are seated; and
  • the seatbelt(s) must be in actual use and properly fastened at the time of the covered accident.
400

Provide 3 medical conditions which may qualify and individual for ADB.

  • Claimants with Stage 4 cancer or mets to multiple organs
  • ALS
  • Advanced Heart Disease
400

To whom can you provide names of beneficiaries?

Only to the beneficiary with who you are speaking or Employer/HR

400

What is Everest? Is there a cost for Everest?

  • Everest is Funeral Concierge Service, available 24/7 to all member and their immediate families free of charge. No
400

Define and explain ICPIP.

  • Insurance Claim Payment Intercept Program
  • Checks for back child support owed by beneficiary and pays back child support to state
500

Explain the Additional AD&D Exposure and Disappearance Benefit.

  • Exposure and Disappearance Benefit: If the accident results in death or dismemberment, due to exposure, or accident results in disappearance and the insured is presumed dead.
500

Define and Explain ADB (including life expectancy period). 

  • is an option for terminally ill members to get a portion of their life insurance prior to death. 
  • the remaining amount is paid to the beneficiary
  • Members are able to receive from 50% to 100% of the value of their life insurance (depending on their policy) to utilize however they choose prior to their death
  • Insured must meet the Life Expectancy period specified in their policy (i.e. 6 – 24 months left to live
500

Can you confirm Suicide or Other Exclusions?

No this can only be confirmed by the Claim Examiner

500

List 5 Services Everest Provides

  • Price Finder Reports:  Everest maintains a nationwide database of all funeral homes and prices, so you can compare and save money
  • Online Planning:  Online tools let members register their specific final wishes for their family members to follow
  • Price Negotiations:  Everest can negotiate prices on your family member’s behalf.  Average savings of $3500 - $5000
  • Everest can find you a caterer, hall, music, limos, flowers – and present it for your approval - - all with one call
  • Everest can assist with having the funeral paid directly from the life insurance proceeds
500

What are the 3 steps for telephonic Life Claim intake?

  • First Check SF (or FIMMAS if Ex-Pat) to Ensure Claim not already received
  • Complete the Life Claim Intake Form
  • Set task in SF. For Expat, Email Life Claims mailbox, Copy Manager on email
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