Disability Claim Information
Our Commitment to You
Eagle American will act as quickly, fairly and compassionately as possible on your claim for disability benefits. We know that loss of time from work due to a disability is stressful. To assist us in doing this, please be sure that any claim form you complete is fully and properly filled out before submitting it to us. Wrong information or no information on the claim form will cause us to send it back to you for corrections.
What Credit Disability Insurance Covers
Credit disability insurance is designed to pay monthly payments that approximate the monthly payments that you make for your loan in the event you are unable to work for at least a minimum amount of time as a result of a sickness or accident. The exact monthly benefit (the amount we pay each month) is determined by summing up the total payments you are obligated to make on your loan and dividing this figure by the total numbers of months that the loan is expected to be in place. Most of the time, this will be your monthly loan payment, but differences may occur if your loan is paid on a basis that is other than monthly (quarterly, semi-annually, etc.) or if your loan has a first payment date that is more than 30 days from the date that the loan is taken out. You must be totally disabled for us to consider benefits. Total disability is defined as: due to sickness or accident, the complete inability to perform the substantial and material duties of any gainful occupation that you are qualified for on the basis of education, training or experience and provides you with substantially the same earning capacity as you had prior to the start of the disability.
What Credit Disability Insurance Does Not Cover
Generally, Eagle American Life will not be liable for the payment of any benefits for disability if the disability: (1) results from normal pregnancy, childbirth or miscarriage; (2) results from any intentionally self-inflicted injury or attempted self-destruction; (3) is a result of war, whether declared or undeclared; (4) was caused by, or contributed to by, an accident, sickness, disease or physical condition for which you received medical advice, consultation or treatment during the six month period immediately preceding the Effective Date of the policy or certificate and which would ordinarily be expected to materially affect your health during the period of coverage. No disability beginning 12 months after the Effective Date of your policy or certificate will be excluded from coverage under this provision; (5) results from your commission of or attempt to commit a felony or to which a contributing cause was your being engaged in an illegal occupation. (6) results from your being intoxicated or under the influence of narcotics unless administered on the advice of a physician.
Certain policies or group certificates may vary slightly from information listed above. Please refer to your policy or group certificate for exact information on what is not covered.
When We Will Consider Your Claim
You must be totally disabled anywhere from 7 to 30 days before you become eligible for disability benefits. The time period is shown on your insurance policy or certificate of coverage under the category of “Waiting Period”. If you are unable to locate your policy or certificate, please contact us at 318-240-8696 and we will be happy to assist you. Generally, we consider benefits in round monthly payments and would like to see your initial claim form submitted to us approximately 30 days after you initially became disabled, if you have been disabled the minimum required time.
If you believe you have suffered a disability that is covered by your policy or group certificate and you have been out of work 30 days or more, you may complete a Disability Claim Form and submit it to us at your earliest convenience.
Your Claim Responsibilities
You must provide us with truthful, accurate and timely claim forms and any other reasonably necessary information or documents that will assist us in processing your claim accurately. Claim forms may be sent to you no more frequently than monthly. Please be advised that you may be violating state law if you knowingly conceal material facts or submit a claim form that contains materially false information. You have the right to decline to provide Eagle American with the requested information or documents, but Eagle American has the right to discontinue processing of your claim if you choose to deny us access to information that is reasonable and necessary to process your claim.
Processing Time, Payment of Claims and Your Loan Responsibilities
If this is your initial claim for disability benefits, please allow up to four weeks for processing time. If this is a continuing claim, please allow up to two weeks for processing time. You should continue to make loan payments until you hear from us. Payment of claims is made directly to your financial institution unless your loan has been fully repaid or your financial institution directs us to do otherwise.
It is your responsibility to keep your loan payments current and pay any late fees, if they are assessed. Insurance is designed to repay your loan if you are disabled, but we make no guarantees to keep your loan current due to processing restrictions. The financial institution may contractually charge late fees and report to credit agencies, even if you have insurance on your loan. Also, disability insurance is typically paid for PAST time off work and this means our payments most likely will be received AFTER your loan payment is due. To avoid late fees on loans, please continue to make your loan payments until you receive information from us indicating that we have sent payment to your financial institution.
Contestability of Coverage and Pre-Existing Conditions
Because your original application for insurance was most likely our primary source of information in accepting your application, we may conduct a review of the accuracy of your answers on this application when you submit your initial claim form to us (if you file within two years after taking coverage out). If, upon review, materially incorrect information is found on your application, your claim may be denied and your coverage may be considered void as of the Effective Date. In this situation, we will refund 100% of your premium and provide you with a complete description of what information we relied upon in making our decision. Also, we may verify whether or not your disability is a result of a medical condition that fell within the pre-existing period contained in your insurance policy or certificate. If your disability is a result of a pre-existing condition, we may not make payment on your claim. Please read the “Exceptions” or “Exclusions” area of your policy or certificate for more information.