Death and Critical Illness Claims Guide

Transcription

1 For Express Claim If your claim meets the requirements below, it is eligible for the express payment process. (Death claim only) How to submit a claim? Total Sum Insured per policy up to $99, The policy has been in force for more than eight years without interruption The policy must not have been assigned as collateral The beneficiary is not a company The beneficiary is not a minor The death occurred in Canada or in the United States The cause of death is not a murder No bankruptcy was reported By phone: By claims.life-ci@ia.ca By fax: By mail: ia Financial Group Life & Health Claims (IRG 2506) P.O. Box 1907, Station Terminus Quebec, (Quebec) G1K 7M3 Claims department will advise if any other requirements are necessary. If your claim does not qualify for an express payment, please follow the instructions in the table below to determine which documents to attach to your claim. ia Financial Group is a business name and trademark of Industrial Alliance Insurance and Financial Services Inc. 1

2 Protection Home Protection Plan Access Life Deferred/Deferred Plus Access Life Immediate/Immediate Plus Requested Documents Form F55-21A Death Claim - Claimant s Statement Form F55-22A Proof of death - Attending Physician s Statement required if the policy meets the following conditions: Total Sum Insured per policy $100,000. and date of issue 10 years Total Sum Insured per policy $50,000. and date of issue 5 years Last Will/Testament required if the insured capital is > $500,000. Other required documents: Copy of last mortgage renewal Mortgage balance as of death, confirmed by lending institution Total Sum Insured, including any riders $25,000. and date of issue 5 years Not required if natural death in the first two years Total Sum Insured per policy $100,000. and date of issue 10 years Total Sum Insured per policy $50,000. and date of issue 5 years Last Will/Testament required if the Total Sum Insured per policy is > $500,000. ia Financial Group is a business name and trademark of Industrial Alliance Insurance and Financial Services Inc. 2

3 Accifamily If the policy does not meet this condition, provide proof of death (see table 1). Alternative Total Sum Insured, including any riders $25,000. and date of issue 5 years Not required if natural death in the first two years Joint Last to Die Life Insurance (Required for each death) Individual Life Insurance (Traditional or universal policy) Pick-A-Term Kitty Waiver of premiums at policyowner s death Total Sum Insured per policy $100,000. and date of issue 10 years Total Sum Insured per policy $50,000. and date of issue 5 years Last Will/Testament required if the Total Sum Insured per policy is > $500,000. Form Critical Illness Claimant s Statement (F37-20A) Date of issue 2 years If the policy does not meet this condition, provide proof of death (see table 1). ia Financial Group is a business name and trademark of Industrial Alliance Insurance and Financial Services Inc. 3

4 Perspective Sum Insured $25,000. and date of issue 5 years Peek-a-Boo Proof of death (see table 1). Accelerated Death Form F35-56A Accelerated death benefit Benefit Available only if life expectancy is reduced to less than 2 years. The request must be made by the owner and there must be a first degree relationship between the owner and the insured. If the beneficiary is irrevocable, the beneficiary must sign the request. Available benefit limited to 50% of the value of the death benefit up to a maximum of $100,000. (any previous loan on the contract will be taken into account in calculating the amount available) The benefit is a loan with interest. A loan agreement between IA Financial Group and the claimant will be issued. Premiums remain payable and guarantees remain in effect. Accidental Death Benefit Final report of the coroner or medical examiner after investigation (may take 9-12 months before being available) It will be helpful if Newspaper clippings are attached to the claim Do not wait for the coroner s final report to submit the claim for the basic amount. Critical Illness Form F37-20A Critical Illness Claimant s Statement Cancer: photocopy of the pathology report confirming the diagnosis Myocardial infarction: photocopy of the electrocardiogram (ECG) and blood test results Multiple sclerosis: photocopy of the result of magnetic resonance imaging (MRI) ia Financial Group is a business name and trademark of Industrial Alliance Insurance and Financial Services Inc. 4

5 F55-21A Form Death Claimant s Statement Table 1 - Additional Information Regarding Required Documents Proof of death F55-22A Form F55-22A Proof of death - Attending Physician s Statement To be completed by the family doctor if date of issue 5 years To be completed by the attending physician if date of issue > 5 years Charges for completing the form are the responsibility of the claimant Required at all times for a child under two years of age OR one of these options: Certificate issued by provincial authorities Official certificate of a hospital confirming the death Certificate of a funeral home Statement signed by a coroner or a medical examiner or other medical practitioner who has attested the death F37-20A Form Critical Illness Claimant s Statement Last Will /Testament Always required if the insured amount is > $500,000. Required only if it contains a provision relating to the insurance contract that is more recent than the last Beneficiary designation known by the Company Required if the owner is deceased and no Contingent owner has been designated Birth Certificate Required only if there is a discrepancy in the documents or if the beneficiary is a minor ia Financial Group is a business name and trademark of Industrial Alliance Insurance and Financial Services Inc. 5

6 Table 2 - Additional Information Minor beneficiary QUEBEC The form F55-21A Death Claim Claimant s Statement must be completed by the legal guardian, who is usually a surviving parent. It is necessary to enclose the birth certificate of the minor child beneficiary to know the name of the parents of the child. It is also necessary to indicate the addresses and social insurance numbers of the child and the parents. OTHER PROVINCES The declaration must be signed by a designated trustee, if designated, or by a "Guardian to the Property of the Child appointed by a Court Order". Payment will be made in accordance with applicable provincial legislation. The current address of the child must be indicated. Foreign Death (A death in the United States is not considered a foreign death) Form F55-21A Death Claim Claimant s Statement Original proof of death obtained from the authorities of the country where the death occurred Form F55-22A Proof of death - Attending Physician s Statement completed by the doctor who certified the death or other document produced by a hospital if the death occurred in a hospital Police report if death is accidental Form F55-22A Proof of death - Attending Physician s Statement if the form is required according to the Death and Critical Illness Claims Guide Passport Airline ticket (if applicable) Foreign Death Questionnaire; to obtain this questionnaire, contact Life & Health Claims at: claims.life-ci@ia.ca Original documents will be returned upon settlement of the claim. Appointment of a new policyowner following death (Death of an QUEBEC If the deceased is the sole owner of the contract and no contingent owner has been designated: the declaration on the back of F55-21A - Death Claim Claimant s Statement must be completed by following the instructions therein. ia Financial Group is a business name and trademark of Industrial Alliance Insurance and Financial Services Inc. 6

7 uninsured policyowner or death of a policyowner; multiple insured) If there is more than one owner, the new owner will be determined according to the contingent owner designation, if there is one. If no contingent owner had been appointed, the deceased owner's share will be allocated according to the last will or testamentary disposition, if any. Otherwise, it will be attributed to the policyowner s estate. OTHER PROVINCES GOVERNED BY "COMMON LAW" If the deceased is the sole owner of the contract and no contingent owner has been designated, the declaration on the reverse side of F55-21A - Death Claim Claimant s Statement must be completed by following the instructions therein. If there is more than one owner, the surviving owner (s) will become the owner of the contract, unless otherwise specified in the application or in any other written document thereafter submitted. Collateral assignment If the policy is collaterally assigned, the assigned portion of the benefit will be paid jointly to the beneficiary and the assignee. If the assignment is no longer in force, a copy of the release of assignment is required. ia Financial Group is a business name and trademark of Industrial Alliance Insurance and Financial Services Inc. 7