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Life Insurance
Q: How do I collect on a life insurance policy?
You are entitled to proceeds of the life insurance policy if you are listed as a beneficiary in the deceased's policy. There are two basic kinds of life insurance policies, which the deceased may have had: individual and employer-sponsored group policies. Individual policies typically are obtained by people on their own, often through an insurance agent. Group coverage typically is obtained as part of an employee's benefits package. Many employers provide coverage with death benefit protection equal to a worker's salary or twice his or her salary.
Who do I contact to make a claim for individually purchased life insurance?
The beneficiary of a life insurance policy starts the claim process by notifying the insurance company. If the insurance was obtained through an insurance agent, he or she can help walk you through the process. If no agent was used or you do not know who the agent is, you can contact the life insurance company directly. Many companies have set up toll-free hotlines and websites to help families file claims.
If you don't know who the insurance agent or the insurer is, look for any records that might contain information identifying the agency, policy or insurer, such as:
- statements (bills) from the insurance company or agency;
- insurance renewal notices; or
- check registers or bank statements that may show payments made to an insurer.
The American Council of Life Insurers has comprehensive contact information for life insurance companies on its website, www.acli.com. The New York State Insurance Department website provides information to contact the insurers' catastrophe centers at: www.ins.state.ny.us/wtccats.htm. The NY State Insurance Department has also established a disaster hotline, (800) 342-3736, which is available from 9 a.m. to 5 p.m. seven days a week.
What if the life insurance coverage was provided as an employee benefit?
First contact the employer and inform them you would like to apply for death benefits on the employer's group life insurance policy. You should request a copy of the summary plan description (SPD) for the life insurance plan. In many cases, employers will get some or all of the benefits for you. Others may not be able to do so and you may have to apply for benefits from the life insurance company yourself as you would for an individual policy. Because the WTC disaster has disrupted many businesses, it may take longer to obtain benefits.
What do I need to submit to the insurer?
Life insurance companies typically pay claims on insured lives upon receipt of a death certificate for the insured and a claim form. Because death certificates may not be immediately available for people who died at the WTC disaster, many insurance companies are accepting a sworn affidavit in lieu of a death certificate. A simple, one-page form, called an Affidavit in Lieu of Death Certificate, was devised especially for the WTC disaster by insurance companies and regulators. That form is available on the New York State Insurance Department website at: www.ins.state.ny.us/acrobat/affidav.pdf. See also the Death Certificates Section of this Handbook.
Many insurance carriers have instituted other emergency measures for the processing of claims for those affected by the WTC disaster. An emergency plan may have been filed with the New York State Superintendent of Insurance. You may contact the New York State Insurance Department to find out about the insurer's emergency plan at www.ins.state.ny.us/wtcdisas.htm.
Your insurer may send you claim forms. These must be filled out, signed and returned within a period of time stated on the forms. Be sure to return all forms on time and to keep records of all communications to and from the insurance company, including correspondence, faxes, e-mail messages and telephone notes.
Several life insurance companies have announced plans to waive deadlines for premium payments for families affected by the WTC disaster. Contact your agent or company to learn more.
How long will it take to receive benefits once I complete the application for benfits?
Life insurance companies typically attempt to pay claims within 30 days of receiving a death certificate on the insured. See the Death Certificates Section of this Handbook.
What should I do if my claim is denied?
If the insurance was provided by an employer, you must follow the claims procedure set out in the SPD. Otherwise, you should object to the denial in writing, and ask the insurer to reconsider. If you have new information pertinent to your claim, provide it.
If you opt to bring a lawsuit against the insurance carrier, you must
do so within the time frame specified in the insurance policy or state
law. Certain policies require an internal review or "appeal"
process before you may sue, so read all policy materials carefully. You
should contact a lawyer if you are considering bringing a lawsuit.
