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Q. How do I file a Critical Illness claim?
You may call our toll free number 1-800-635-5597 to request a claim form or you can click on the link below which will direct you to a location on our website where you can download and print your claim form. Once you have clicked on the link below, select:
- Claim forms
- State in which your policy was issued (usually the state you signed your application in); and
- Product you are filing a claim on http://w3.unum.com/fmtw/employer/CategoryState.aspx?strLOB=VISTD&Title=View,%20Print,%20Order&strIsWizard=true
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Q. How do I file a claim for the Health Screening Benefit?
Submit a completed claim form or a copy of your test results for consideration of benefits. Benefits are paid for the Health Screening Benefit once per covered person per calendar year.
We make every effort to ensure the initial review of a claim is completed within 5 business days. This means we will review the information you provided and determine if we can issue benefits or if additional information is needed.
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Q. What will happen once my claim has been filed?
Unum is committed to providing prompt service. We make every effort to ensure the initial review of a claim is completed within 5 business days. This means we will review the information you provided and determine if we can make a decision or if additional information is needed. We will send you correspondence to let you know the results of our initial claim review and in many cases will even attempt to reach you over the phone so you know as soon as possible.
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Q. What can I do to avoid delays in the processing of my claim?
Please insure that all information requested on the claim forms is completed and signed and all necessary documentation requested is provided. Make sure to include copies of all testing, such as pathology reports, surgical reports and medical notes in regards to the condition for which you are filing for benefits.
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Q. Who will review my Critical Illness claim?
Once we receive your completed claim forms, you will be provided with direct access to a Voluntary Benefits Specialist who will personally handle your needs. This contact, an individual trained in your specific type of disability, will evaluate your claim and issue benefits to you.
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Q. Is anyone else involved in the review process of my Critical Illness Claim?
When appropriate, your Voluntary Benefits Specialist may call or send a written request to your attending physician to better understand your condition. Our in-house physicians, nurses and case managers support our Voluntary Benefits Specialists and may also be in touch with your doctor. These professionals may also review your medical records to assist in benefit determination.
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Q. What if I have questions about my Critical Illness claim?
During your first conversation with your Voluntary Benefits Specialist, you will receive a toll-free number that you can use whenever you need to reach him or her with questions or concerns about your claim. You can also access our website, unum.com.
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Q. If my claim is approved, what will happen next?
We will communicate an approval to you in writing and in many cases will also try to contact you by phone. If a payment is due, it will be sent out under separate cover.
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Q. What happens if I disagree with Unum's decision on my Critical Illness claim?
Our claims process is designed to ensure that your claim receives a thorough, fair and objective evaluation. In addition, numerous safeguards are in place throughout the process to ensure the integrity of decisions that result from our evaluation. If we determine that benefits are not payable either in whole or in part, you may appeal the decision by requesting a separate, impartial review from our Appeals Unit.
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Q. If I am issued the full face value of my policy can it be used again for another Critical Illness?
This policy will terminate upon payment of the available Face Amount as defined in the Policy or in any other attached supplementary benefit.
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Q. What should I do if I have not received my check?
You may call our Contact Center at 1-800-635-5597 to inquire about the status of your check and the address to which it was mailed. If the address is correct, please allow 10 business days from the date of issue for the check to be delivered. If a check is inadvertently mailed to the wrong address, the check will be stopped and reissued immediately. If the address is correct, but the check is not received within 10 business days, ask to speak to your Benefit Specialist.
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Q. Are my benefits taxable?
No, your benefits are not taxable. Your policy premiums are deducted from your paycheck after your taxes have been deducted; therefore, the benefits cannot be taxed.
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Q. Where can I find my benefit amount, what is covered and who is covered under my policy?
You will find this information noted on the front page of your Policy Schedule.
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Q. Where would I find a copy of my Critical Illness policy?
You may call our Contact Center at 1-800-635-5597 and request the Policy Services Department. Be ready to provide your policy number or social security number as this information is used to locate your policy information.
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Q. I have more than one policy with Unum. Can the premiums for each of my policies be deducted from my benefit payment?
No. The only premiums that can be deducted from your benefit check are the premiums for the policy in which benefits are being paid. You will need to contact Policy Services to arrange a payment method for premiums due for additional policies.
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