MR. WATSON: First thing you do is get sick. (Coughing.) You have how many days to notify the company of a claim?
ALL: 20.
MR. WATSON: They have how many days to send you claim forms? They have to send me claim forms within how many days?
ALL: 15.
MR. WATSON: I like my whiskey "90 proof." This means that I’ve returned the completed claims forms back to the insurance company. The insured has 90 days to send the company proof of loss, to complete and return the claim forms.
MR. WATSON: Then they have to pay me within how many days?
ALL: 45.
MR. WATSON: Very good. Let's try this again. This is one-third of G BENT CLIPPER.
Notice of Claim
MR. WATSON: The "N" is notice of claims provision. How many days for you to notify the company of your claim?
ALL: 20.
Claim Forms
MR. WATSON: The "C". Claim Forms. If the company does not send you claim forms within the time limit, you may submit proof of loss in any form.
MR. WATSON: "Claim forms" - how many days does the company have to send them to you?
ALL: 15.
Proof of Loss
MR. WATSON: The "P" is proof of loss. How many days?
ALL: 90.
MR. WATSON: There is also a time limit for submitting proof of loss and that is one year. The only exception is if you don't have the legal capacity to comply. You're in a coma.
MR. WATSON: Also, if loss involves disability income payments for two or more years, you have to submit proof of loss every six months.
ALL: Every six months.
Time Payment of Claim
MR. WATSON: The "T". Time Payment of Claims. How many days? 45 days. Guys, if the company is paying disability payments, they have to be paid how often?
ALL: Monthly.
MR. WATSON: If the claim involves disability income payments, they must be paid at least monthly.
Payment of Claim
MR. WATSON: The "P". Payment of Claim. This part of the policy says how and to whom the claims are paid. How and to whom.
MR. WATSON: If you die and it's an A.D.&D. policy, who is it going to pay? Going to pay a beneficiary. Very good.
Exam or Autopsy
MR. WATSON: The "E". Exam or Autopsy. Remember, if the insurance company requests the medical or physical exam, they also pay for it. Same goes for an autopsy.
Legal Action
MR. WATSON: The "L." Legal action.
MR. WATSON: The insured can not take legal action against the company until after 60 days from the time the insured submitted proof of loss, and it must be done within five years. And remember, submitting proof of loss means returning the completed claims forms back to the insurance company.
Beneficiary
MR. WATSON: The "B". Beneficiary. If someone is named as irrevocable beneficiary then the beneficiary can’t be changed without the irrevocable beneficiary’s consent.
- Primary,
- Secondary (Contingent) or
- Tertiary (Third, also contingent)
MR. WATSON: So let’s say that my wife Lisa is my primary beneficiary, if living, otherwise, my three sons to get the benefit. Can I do that?
WOMAN: Yes.
MR. WATSON: Of course I can. The sons are secondary beneficiaries or contingent beneficiaries. So when I die, the insurance company is going to see if Lisa is living. If she's living she gets the money.
MR. WATSON: But if she died before I died, it drops down to the secondary beneficiary, these three guys. They're known as contingent beneficiaries, which is any other than primary.
MR. WATSON: I want:
- my wife to be the primary beneficiary if living; otherwise,
- my three sons to be my secondary beneficiary if living;
- otherwise, the church. The church would be the tertiary beneficiary, the third in line. What's "tertiary" mean?
ALL: Third.
MR. WATSON: If no beneficiary is named when I die or if they're all dead when I die, it goes to my (policy owner) estate. Then, my estate will go through probate. Probate means to "prove" a "will." Got it?
ALL: Yeah.