How to Submit a Life Waiver of Premium Claim

Transcription

1 39317GAMENGGL 10/13 Disability and Life Online Claims Submission Employee Manual

2 Table of contents Introduction 3 Getting Started 4 Submitting an Accidental Dismemberment claim 5 Submitting a Living Benefit claim 12 Submitting a Life Waiver of Premium claim 19 Submitting a Short-Term Disability claim 28 Submitting a Long-Term Disability claim 37 2

3 Introduction Our online claim submission site provides a convenient way for you to submit disability claims (short-term and long-term disability) and life waiver of premium, accidental dismemberment and Living Benefits claims. It saves you time by not having to mail or fax your claim to us and can speed up the process because your claim gets sent directly to our system. This manual offers step-by-step instructions on how to submit your claims online. If you have questions, you can call us at: }} For life claims: }} For disability claims:

4 Getting Started You ll select the type of claim you want to submit on the Welcome screen. The options are: }} Accidental Dismemberment }} Living Benefit }} Life Waiver of Premium }} Short-Term Disability }} Long-Term Disability Fields marked with an asterisk* are required. 4

5 Submitting an Accidental Dismemberment claim To submit a claim for an accidental dismemberment, select Accidental Dismemberment in the Type of Claim field. In the Type of User field, select Employee. Enter the characters you see in the bottom box, then click Next. 5

6 A pop up message will appear showing the additional forms you will need to complete your claim. You can click on the links to download and print fillable PDF versions of the forms: }} Employer s Statement }} Attending Physician Statement 6

7 Please give us as much information as possible on the Employee/Employer Information screen. 7

8 On the Accident Information screen, give us as much information as you can about the accident that caused the loss. 8

9 If you have forms completed at the time you enter the claim, you can scan them and upload them on this screen. For example, if you have Employee s Statement and/or Attending Physician Statement you can scan and attach them here. 9

10 Next, you ll get confirmation of the information you entered and you ll give your certification to us that we can begin processing the claim. You can also enter your address and we ll send you confirmation of all the information you entered. 10

11 Once the claim is complete, you ll receive a confirmation summary showing all the information you entered. If you entered your on the prior screen, you ll also get a confirmation summary by . 11

12 Submitting a Living Benefit claim To submit a claim for a Living Benefit (Accelerated Death Benefit), select Living Benefit in the Type of Claim field. In the Type of User field, select Employee. Enter the characters you see in the bottom box, then click Next. 12

13 You can print the forms we need to process the Living Benefit claim from this screen. Click on the links to get fillable PDF files of the forms: }} Employee s Statement }} Attending Physician Statement }} Disclosure Statement 13

14 On the Employee Information screen, you ll give us the information we need to begin processing of the Living Benefit claim. Be sure to give us as much information about the medical condition as you can. 14

15 You ll enter your Employer s contact information on the Employer Information screen. 15

16 If you have forms completed at the time you enter the claim, you can scan them and upload them on this screen. For example, if you have Employee s Statement, Attending Physician Statement, and/or Disclosure Statement you can scan and attach them here. 16

17 Next, you ll get confirmation of the information you entered and you ll give your certification to us that we can begin processing the claim. You can also enter your address and we ll send you confirmation of all the information you entered. 17

18 Once the claim is complete, you ll receive a confirmation summary showing all the information you entered. If you entered your on the prior screen, you ll also get a confirmation summary by . 18

19 Submitting a Life Waiver of Premium claim To submit a claim for a Waiver of Premium for life insurance, select Life Waiver of Premium in the Type of Claim field. In the Type of User field, select Employee. Enter the characters you see in the bottom box, then click Next. 19

20 You can print the forms we need to process the Life Waiver of Premium claim from this screen. Click on the links to get fillable PDF files of the forms: }} Life Waiver of Premium Employer s Statement }} Life Waiver of Premium Attending Physician Statement 20

21 On the Employee/Employer Information screen, you ll give us the information we need to begin processing your Life Waiver of Premium claim. Be sure to give us as much information about the medical condition as you can. 21

22 Next, you ll give us information about your disabling condition. Be sure to provide as much detailed information as you can. 22

23 (Continued) 23

24 If you have forms completed at the time you enter the claim, you can scan them and upload them on this screen. For example, if you have the Life Waiver of Premium Employer s Statement or Life Waiver of Premium Attending Physician Statement, you can scan and attach them here. 24

25 Next, you ll get confirmation of the information you entered and you ll give your certification to us that we can begin processing the claim. You can also enter your address and we ll send you confirmation of all the information you entered. 25

26 (Continued) 26

27 Once the claim is complete, you ll receive a confirmation summary showing all the information you entered. If you entered your on the prior screen, you ll also get a confirmation summary by . 27

28 Submitting a Short-Term Disability claim To submit a claim for Short-Term Disability, select Short-Term Disability in the Type of Claim field. In the Type of User field, select Employee. Enter the characters you see in the bottom box, then click Next. 28

29 You can print the forms we need to process the Short-Term Disability claim from this screen. Click on the links to get fillable PDF files of the forms: }} Attending Physician Statement }} Individual Authorization Form }} Reimbursement Agreement 29

30 Enter your contact information and all the information you have about your disabling condition. Be sure to give us as much detail as you have, to help us process your claim. 30

31 Next, enter your Employer s contact information and information about your job. 31

32 Next, you ll give us information about your disabling condition. Be sure to provide as much detailed information as you can. 32

33 Be sure to provide as much detail as you can to help us in processing your claim. 33

34 If you have forms completed at the time you enter the claim, you can scan them and upload them on this screen. For example, if you have the Attending Physician Statement, Individual Authorization Form, and/or Reimbursement Agreement you can scan and attach them here. 34

35 Next, you ll get confirmation of the information you entered and you ll give your certification to us that we can begin processing the claim. You can also enter your address and we ll send you confirmation of all the information you entered. 35

36 Once the claim is complete, you ll receive a confirmation summary showing all the information you entered. If you entered your on the prior screen you ll also get a confirmation summary by . 36

37 Submitting a Long-Term Disability claim To submit a claim for a Long-Term Disability, select Long-Term Disability in the Type of Claim field. In the Type of User field, select Employee. Enter the characters you see in the bottom box, then click Next. 37

38 You can print the forms we need to process the Long-Term Disability claim from this screen. Click on the links to get fillable PDF files of the forms: }} Attending Physician Statement }} Individual Authorization Form }} Reimbursement Agreement 38

39 You ll enter your contact information and your Employer s contact information on this screen. 39

40 Be sure to give us as much information about your job as you can. 40

41 Enter information about the disabling condition on this screen. Be sure to provide as much detail as you can to help us in processing your claim. The questions will change based on the Reason Stopped Work chosen: }} Illness }} Injury }} Maternity 41

42 No matter the Reason Stopped Work chosen, you will need to give as much information about your doctor and your other income as possible. 42

43 If you have forms completed at the time you enter the claim, you can scan them and upload them on this screen. For example, if you have the Attending Physician Statement, Individual Authorization Form, and/or Reimbursement Agreement you can scan and attach them here. 43

44 Next, you ll get confirmation of the information you entered and you ll give your certification to us that we can begin processing the claim. You can also enter your address and we ll send you confirmation of all the information you entered. 44

45 Once the claim is complete, you ll receive a confirmation summary showing all the information you entered. If you entered your on the prior screen you ll also get a confirmation summary by . 45

46 Life and Disability products are underwritten by Greater Georgia Life Insurance Company (GGL) using the trade name Anthem Life, independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered trademarks of the Blue Cross and Blue Shield Association. greatergeorgialife.com 46