Filing a Claim

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	Personal Accident Insurance Plan

	The Plan at a Glance

	Participating in the Plan

	How the Plan Works

	How Benefits Are Paid

	Filing a Claim

	Glossary

Filing a Claim

To get a claim form, you or your beneficiary should contact the Claims Administrator and return the form as it instructs.

These documents will need to be included with your claim:


Type of loss	Documents required
Death	a claim form a certified death certificate an accident report a copy of any newspaper articles if available a certified copy of the court appointment naming the guardian of the estate, if beneficiary is a minor proof of age of the beneficiary a police report
Dismemberment	a claim form a police report an accident report listing of all doctors and hospitals treating the insured for this injury

The loss must be directly related to the injuries from the accident and take place within 365 days of the accident to be covered under the Plan.

The beneficiary needs to file the claim within 90 days of the date of loss.

How does claims processing work?

After the insurance company receives the proper documents and approves the claim, a check will be sent to the beneficiary's home address.

How long does it normally take to process a claim for benefits?

Most claims are normally processed within two weeks after the claim is filed.

How do I appeal a benefit determination or denied claim?

There are special rules, procedures and deadlines that apply to appeals of benefit determinations and denied claims, and you have special legal rights under ERISA. Please refer to the Plan Administration Description for a description of the appeal process.