In the event that you need to file a claim for insurance benefits, we will gladly
assist you throughout the entire claims process. Your dedicated Claims Specialist
will review your claim and respond to your request as quickly as possible, while
offering as much guidance and support as you may need.
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Debbie Wagner
Life & Disability Claims Team Leader
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How to file a claim
Simply download and complete the appropriate claim form
(or contact us at 866-257-0707), and then send it to us along with the required
supporting documentation, as listed on the form. For your protection, we ask that
all claims be made in writing. Depending on the type of benefit requested, supporting
documentation may include any of the following:
- Physician's report
- Death certificate
- Monthly P&L statements
- Medical records
- Federal income tax return
Who should file the claim?
Annually Renewable Term Life, Level Term Life or Term Plus®
Universal Life Claims
Claims for an ADA member who is deceased, should be filed by the member's named
beneficiary. If you are unsure of who has been named beneficiary, please contact
Member Services at 800-568-2001.
Most life insurance claims are processed very quickly, pending receipt of all necessary
documentation. We make every attempt to issue benefit checks to beneficiaries within
10 business days after we receive all required information. Please allow a few extra
days for your check to reach you via standard U.S. mail.
Annually Renewable Term Life Disability Waiver of Premium and Term Plus Universal Life Disability Waiver
of Premium claims should be filed by the ADA Member (primary certificate holder).
Disability Income Protection and Office Overhead Expense Claims
The ADA Member (primary certificate holder) should file any claim under the Disability Income
Protection or Office Overhead Expense Plan as soon as possible after the start of
your disability. The review process for disability claims can take up to several
weeks or longer, depending primarily on the timely receipt of critical information
from you and your physicians. Before benefits can be released, reports from your
physicians and clinical records, along with any required financial records for you
and/or your practice, must be reviewed and you must have satisfied your waiting
period.
Your assistance in obtaining clinical information from your physicians and in providing
necessary financial documentation can make a big difference in expediting the review
process.
MedCASHSM Hospital Claims
The ADA Member (primary certificate holder) should file any MedCASH claim, including
those pertaining to a covered spouse or dependent child. Most benefits can be released
once you have satisfied the required waiting period (if any). Hospital Coverage
benefit checks are typically issued within 10 business days after all necessary
claim requirements have been met. Please note that your health insurer's EOB (explanation
of benefits) statement does not provide us with all the information we need to process
your claim.
MedCASHSM Critical Condition Claims
Critical Condition benefit checks are issued as soon as the appropriate survival
period and waiting period have been satisfied, following the receipt of all necessary
documentation. Receipt of your medical records is required for Critical Condition
benefits; in particular, your physician will need to provide a confirming clinical
diagnosis of your qualifying condition before benefits can be paid. In some cases
we may need to request additional information.
Payment of benefits for all Plans is subject to approval based on the qualifications
outlined in your certificate(s). For additional information about claims procedures
or policies, contact us at 866-257-0707 or
ada@greatwest.com.