AD&D 1
ADB
Life Status Calls
AD&D 2
Misc Life Claim
100

Are there exclusions to AD&D coverage?

Yes

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

Explain AD&D.

  • Life coverage in addition to Basic and Supplemental
  • Only applicable if the Manner of Death is Accidental
100

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.
200

What does AD+D stand for?

Accidental Death and Dismemberment

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

What is a 25% covered loss under AD+D?

  • Loss of Thumb and Index Finger of Same Hand
  • Uniplegia (total and irreversible paralysis of one limb.)
200

What is OFAC?

Office of Foreign Asset Control – Terrorist/Terrorism Check

300

What is a 50% covered loss under AD+D?

  • Loss of One Hand or One Foot
  • Loss of Sight of one Eye
  • Loss of Speech or Hearing
  • Hemiplegia (total and irreversible paralysis of both limbs on either side of the body i.e. the right arm and right leg or the left arm and left leg).
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 is a 75% covered loss under AD+D?

  • Triplegia (total and irreversible paralysis of three limbs.)
  • Paraplegia (total and irreversible paralysis of both lower limbs.)
300

Define and explain ICPIP

  • Insurance Claim Payment Intercept Program
  • Checks for back child support owed by beneficiary and pays back child support to state
  • Required for beneficiaries whose residence state is MA or TX
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

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.
400

What are the 3 steps in a telephonic intake?

  • First Check SF to Ensure Claim not already received
  • Complete the Life Claim Intake Template/Form
  • Note and set task in SF to life claims team
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

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

What is a 100% covered loss under AD+D?

  • Loss of Life
  • Loss of Both Hands or Both Feet or Sight in Both Eyes
  • Loss of One Hand and One Foot
  • Loss of One Hand or One Foot and Sight in One Eye
  • Loss of Speech and Hearing
  • Quadriplegia (total and irreversible paralysis of all four limbs.)
500

What is an age reduction and how does it work?

  • Coverage amount will decrease when EE or SP reaches an age specified in the policy/contract. i.e. reduces to 75% at age 70
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