DB Claims 5 - Benefits, Laws & Agencies Flashcards
5
Department of Insurance
State-run agencies that monitor the financial solvency of the insurance companies domiciled in that state so that the legal promises made in insurance policies are honored.
Family Care Benefit
a. This benefit is intended to provide financial incentive for a disabled person to return to work or remain on the job by assisting the disabled employee in their childcare expenses. This benefit reimburses the employee for childcare expenses they would have to pay if they were to return to work or remain on the job. If an employee is disabled, they will most likely discontinue daily childcare for their children. This provides extra income to the employee since they no longer have the expense of childcare. A person may be encouraged to remain on disability since they are receiving a portion of their pre-disability earnings and do not have the additional childcare expenses. By providing the Family Care Benefits for a disabled employee, we can reduce the incentive of a person to malinger on claim. This provision helps the employer by returning the employee to work or influencing them to remain on the job, and also assists the employee with the childcare expenses.
Accelerated Life Benefit
Provision in a group life policy that allows pre-payment of a portion of an employee’s life benefit upon proof of a terminal illness in which the insured is expected to die within 12 months.
Accidental Death and Dismemberment (ADD)
AD&D is a separate coverage that is sold in conjunction with Life Insurance. It is designed to pay a benefit in addition to the Life Benefit in the event of death due to an accident. The dismemberment portion pays a benefit for loss of sight, speech or hearing, or severance or loss of use of limbs, etc. due to an accident. Sometimes referred to as Double Indemnity.
Survivor Benefit
AUL will pay a lump sum benefit to the Eligible Survivor when proof acceptable to AUL is received that the Person died:
- after Disability had continued for 180 or more consecutive days; and
- while a Person was receiving a Monthly Benefit
Social Security Full Retirement Age (SSFRA)
The Social Security Full Retirement Age as figured by the 1983 amendment or any later amendment to the Social Security Act defines the age at which benefits terminate in our benefit duration schedules.
A.D.A.
Americans with Disabilities Act. This federal law prohibits discrimination on the basis of a disability for hiring, compensation, benefits, etc. and requires employers make accommodations as necessary for employees with disabilities. Compliance is the responsibility of the employer.
A.D.E.A.
Age Discrimination in Employment Act. This Federal Law prohibits discrimination on the basis of age in such matters as hiring, job retention, compensation, and other terms, conditions, and privileges of employment. Compliance with the law is the responsibility of the employer.
A.D.L.
The things we normally do in daily living including any daily activity we perform for self-care (such as feeding ourselves, bathing, dressing, grooming), work, homemaking, and leisure. The ability or inability to perform ADLs can be used as a very practical measure of ability/disability in many disorders.
Department of Insurance
State-run agencies that monitor the financial solvency of the insurance companies domiciled in that state so that the legal promises made in insurance policies are honored.
Family Care Benefit
a. This benefit is intended to provide financial incentive for a disabled person to return to work or remain on the job by assisting the disabled employee in their childcare expenses. This benefit reimburses the employee for childcare expenses they would have to pay if they were to return to work or remain on the job. If an employee is disabled, they will most likely discontinue daily childcare for their children. This provides extra income to the employee since they no longer have the expense of childcare. A person may be encouraged to remain on disability since they are receiving a portion of their pre-disability earnings and do not have the additional childcare expenses. By providing the Family Care Benefits for a disabled employee, we can reduce the incentive of a person to malinger on claim. This provision helps the employer by returning the employee to work or influencing them to remain on the job, and also assists the employee with the childcare expenses.
Accelerated Life Benefit
Provision in a group life policy that allows pre-payment of a portion of an employee’s life benefit upon proof of a terminal illness in which the insured is expected to die within 12 months.
Accidental Death and Dismemberment (ADD)
AD&D is a separate coverage that is sold in conjunction with Life Insurance. It is designed to pay a benefit in addition to the Life Benefit in the event of death due to an accident. The dismemberment portion pays a benefit for loss of sight, speech or hearing, or severance or loss of use of limbs, etc. due to an accident. Sometimes referred to as Double Indemnity.
Survivor Benefit
AUL will pay a lump sum benefit to the Eligible Survivor when proof acceptable to AUL is received that the Person died:
- after Disability had continued for 180 or more consecutive days; and
- while a Person was receiving a Monthly Benefit
Social Security Full Retirement Age (SSFRA)
The Social Security Full Retirement Age as figured by the 1983 amendment or any later amendment to the Social Security Act defines the age at which benefits terminate in our benefit duration schedules.
