Filing an insurance claim can feel daunting.
From the time the claim is initiated to the time when benefits are paid, there seems to be a lot of paperwork and exchange of information. Filing a claim under an individual disability insurance (IDI) policy is both very much the same but also very different from any other kind of claim.
For a client who is ill or injured, filing a disability claim may come during a challenging time in his or her life; they could be recovering from an injury, undergoing treatment for cancer or experiencing a psychiatric disorder. A client may be completely unable to work or only able to perform certain aspects of his or her job. Regardless, for a client who has IDI, filing a claim goes beyond simply getting a car repaired after an accident or belongings replaced after a break-in. IDI benefits ensure your client can maintain his or her way of life during recovery.
Helping your clients through the process
As a producer, you've sold your clients an IDI policy through a certain carrier for a reason. While the coverage or pricing may have been part of what sealed the deal, the carrier's claims philosophy and process should also have been considered.
Although there are a number of steps that need to be completed when filing an IDI claim, there are ways you can streamline the process. Here are some helpful tips to remember when one of your clients needs to file an IDI claim.
Initiating a claim
Your client elected IDI coverage for good reason, but probably never thought he or she would actually need to file a claim. So, if and when the time comes, a client's first call may be to you.
As a producer, your service model probably includes taking care of a number of administrative aspects of servicing your plans. However, initiating a claim is one area where the client can take care of it themselves. As a producer, getting stuck in the middle, shuttling questions and information back and forth between the client and the carrier, inadvertently slows down the process and dilutes information needed for the evaluation of the claim. Having your client contact the carrier's claim department directly helps optimize the process.
IDI benefits ensure your client can maintain his or her way of life during recovery. (Photo: iStock)
You can help by making sure that your client is equipped with the following:
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- The phone number of the claims department. This is for initiating the claim and also any follow-up questions, discussions or conversations.
- An understanding of the type of information that will be needed. For notice of claim, this generally includes:
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- When did the disability start?
- What is the cause of disability?
- Where does the client want correspondence/benefits sent?
- Who is treating the client for their condition?
- How has the condition impacted the client's ability to do his or her job?
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- An understanding of the forms that will be sent to the client for completion. At a minimum, these include the Insured's Statement, an Attending Physician's Statement and an authorization form.
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Some clients may be sensitive about the type of information needed to complete the claims process. However, it's not very different from the detailed information they provided when they applied for the policy in the first place. Providing a client with a preview of the information they'll need to submit a claim can help make the process smoother.
Pick up the phone when a claim needs to be filed
This may seem like straightforward advice; however, producers may reach out to the people they know, their contacts in underwriting or sales support, when initiating the process rather than contacting the claims department. Unfortunately, this approach slows down the process.
When a disability happens
Every IDI policy has a waiting period; some are short (only 30 days), while others are much longer (365 or even 720 days). But that doesn't mean that your client should wait that amount of time to inform the carrier about his or her disability. Regardless of the benefit waiting period, the carrier should be contacted right away so that they can gather information about the claim, provide the necessary forms and begin their evaluation. If all the information necessary for a determination is in the claim file, then once the waiting period is satisfied, benefits can usually be paid within 30 days.
Producers should avoid getting stuck in the middle of the client and the carrier as this can inadvertently slow down the claims process. (Photo: iStock)
