LIFE WITH LTC RIDER CLAIMS
Written Notice of Claim: Written notice of claim must be given to Trustmark within 30 days after a covered loss begins, or as soon as reasonably possible after that. The notice should contain Your name and Policy number.
Your notice should identify the Insured and be sent to Trustmark.
- File Claim Online: www.trustmarkbenefits.com/claims
- Policy Claim Form - www.trustmarkbenefits.com/voluntary-benefits/forms
Claim Forms: After Trustmark receives written notice of claim, they will furnish claim forms within 15 days. If they do not, the claimant will have met the requirements for written proof of loss upon submitting a written statement of the extent and nature of the loss within the time limit stated in the Written Proof of Loss provision.
Written Proof of Loss: Written proof of loss must be sent to Trustmark within 91 days after the end of a Grace Period for which benefits are claimed. If that is not reasonably possible, the claim will not be affected. Unless the claimant is legally incapacitated, written proof must be given within one year following the 91-day period for submitting written proof of loss.
Rights Not Waived: None of the following actions shall waive or reduce any of Trustmark’s rights in defense of a claim under this rider:
The acknowledgment by Trustmark of receipt of notice of claim under this rider; The furnishing of forms for filing proof of loss, or the acceptance of such proof, or The investigation of any claim under this rider.
Time of Payment of Claims: After Trustmark receives written proof of loss, benefits will be paid monthly for the Benefit Period claimed. Any accrued benefits remaining unpaid when Trustmark’s liability ends will be paid as soon as they receive proper written proof of loss. Trustmark will require periodic proof of continued eligibility and confinement during a claim.
Payment of Claims: Benefits will be paid to You unless they have been assigned elsewhere. Any accrued benefits unpaid at Your death will be paid to Your Beneficiary, or to Your estate, if no Beneficiary is named.
Physical Examination: At Our own expense, Trustmark has the right to have the Insured examined as often as reasonably necessary while the claim is pending. The right to examine the Insured will not be exercised more often than every 3 months.
In the event of a disagreement between the Physician Trustmark designates to examine You and Your Physician, they will consult a third Physician who has no connection with either Your Physician or Their Physician. The determination of the third Physician will be used to determine the final outcome of the claim.
Claim Denial: If a claim is denied, Trustmark will make available all information directly relating to such denial within 60 days of the date of a written request by You, unless such disclosure is prohibited under state of federal law.
Legal Actions: No legal action can be brought against Trustmark within 60 days after the date written proof of loss is given. It cannot be brought after three years from the date written proof of loss is required to be given.