PRODUCT DESCRIPTION INFORMATION
What is this coverage? Can you tell me more about this coverage? What does this cover?
Accidental Death and Dismemberment covers the insured in the event of loss of life, limb, sight, speech or hearing due to a covered accident.
DEPENDENT and AGE QUESTIONS
- Insured and spouse: 18 and older
- Dependent children: 19 and under, or under 25 if enrolled in accredited institution of higher learning
- No termination age; however, coverage reduces by 50% at age 70 and reduces 25% at age 75
- For example, a customer has $100,000 in supplemental coverage. At age70, the coverage reduces to $50,000 ($100,000 x 50%). At age 75, the coverage reduces to $25,000 ($100,000 x 25%).
BENEFITS
- Offers up to $300,000 of supplemental coverage elected and paid by the primary insured
- Individual or Family coverage available
FAMILY COVERAGE PERCENTAGES
- Spouse without children – 60%
- Spouse with children – 50%
- Child(ren): 20%
ADD ON BENEFITS:
- You only need to read the description for the benefit being asked about
Return of Premium – If primary insured dies and it is determined that accidental death benefit is not payable the return of premium benefit will be paid in a lump sum.
Adaptive Home and Vehicle Benefit – If your home and / or private motor vehicle require modifications to accommodate a dismemberment or total and permanent disability resulting from a covered loss, we will pay an additional benefit.
Air Bag – If you suffer an accidental death which occurs while you are driving or riding in a private passenger car, we will pay an additional benefit equal to the lesser of $25,000 or 25% of the amount of your contributory coverage payable.
Motorcycle Helmet – If you suffer an accidental death while you are driving or riding on a motorcycle, we will pay an additional death benefit of $10,000.
Total and Permanent Accidental Disability Benefit (FL ONLY) – If the insured becomes totally and permanently disabled as the result of a covered accidental injury prior to age 60, the plan provides a monthly benefit of 1% of the additional coverage amount, plus monthly premiums due.
What is a common carrier?
“Common Carrier includes any public air, land, or water conveyance operated under a license for commercial passenger service.”
HYPOTHETICAL or “IS THIS COVERED” SCRIPTING
- IF CUSTOMER WANTS TO KNOW IF SOMETHING SPECIFIC IS EXCLUDED OR WANTS EXAMPLES OF WHAT COULD BE COVERED
“I will be happy to help you better understand the benefits and exclusions of this insurance plan.”
What is covered?
This accidental death and dismemberment insurance provides benefits in the event of an accidental death and for loss of limb, sight, speech, or hearing as the result of a covered accident. Some common types of accidents that may be covered are slip and fall injuries and motor vehicle accidents. The facts and circumstances of each claim are thoroughly reviewed to determine whether the injury is a covered loss under this limited benefit policy and whether any policy exclusions apply.
This insurance does not pay benefits for death due to natural causes or suicide. Other common exclusions are when you die in a motor vehicle accident where you are the driver and your blood alcohol level exceeds the legal limit; commission of a crime, assault or felony; use of drugs and alcohol: and acts of war. Each claim is thoroughly evaluated to determine if a benefit is payable according to the terms of the policy. Exclusions vary by state.
Is this (Hypothetical) death covered? (Follow up – Part 2, if needed)
- IF CUSTOMER WANTS A DEFINITIVE ANSWER AS TO WHETHER OR NOT A SPECIFIC CONDITION IS COVERED
You have really good questions. I do realize you are asking about (HYPOTHETICAL) and it is the carrier who reviews claims and determines whether a benefit is payable. If you have a claim, we encourage you to file it for a formal claim decision. Keep in mind that if the situation you describe is not covered, there are countless, unknown situations that are covered.
ENROLLMENT
Do I automatically receive the no-cost basic insurance?
“No. you must complete and return the enrollment form.”
Do I have to purchase additional coverage to receive my complimentary coverage?
“No. The Complimentary coverage is given to you as a valued customer.”
How much additional coverage may I choose?
“You alone can decide how much coverage you need. AD&D insurance has coverage levels to fit your budget, from $10,000 to $300,000.”
Who can I name as my beneficiary?
“Name anyone or as many beneficiaries as you would like.”
Can I get insurance for my spouse and family, too?
“Yes. Family insurance covers you, your spouse/domestic partner and/or dependent children at a percentage of your coverage amount.”
Who is covered under the family plan?
“The Family Plan would provide coverage for yourself, your spouse/domestic partner and any eligible dependent children that you may have. Please refer to your Insurance Coverage Document for more detailed information.”
How do I enroll?
“Simply complete and sign the enrollment form and send it to the Plan Administrator in the reply envelope provided in your package or you can enroll online using the Invitation Code or QR Code on your Activation form.”
I lost or threw away my envelope. What is the address to send the paperwork to?
“You can mail it to:
Benefit Plan Administrator
P.O. Box 689070
Franklin, TN 37068-9070″
Do I have to take a medical exam or answer a lot of health questions? Can I be turned down?
“No. Medical exams, blood tests or answering health questions are not required to enroll and or keep this coverage. Your acceptance is guaranteed.”
CANCELLATION
Can I cancel / Can I get my money back?
“If you are not happy with this insurance for any reason, you may cancel at any time and all billing will stop.”
RATES AND BILLING
Do the rates go up?
“Your rates will not go up on an individual basis or because you have filed a claim. As a group, rates may be changed on a class basis.”
How will I be billed for this coverage?
“You will be conveniently billed to the account provided at the time of enrollment.”
Can I get billed directly?
“You will be conveniently billed to the account provided at the time of enrollment.”
FULFILLMENT AND EFFECTIVE DATES
When will I receive the certificate of insurance?
“You can expect to receive the certificate of insurance within 15 days of your enrollment.”
When does coverage begin?
“Your effective date will be shown on your certificate of insurance that you will receive within 15 days of your activation. Please note that your effective date may be delayed depending on the billing cycle of your financial institution.”
CLAIMS
How are benefits paid?
- Benefits for loss of life will be payable in accordance with the Beneficiary provision and these Claim Provisions.
- All other proceeds payable under this Policy, unless otherwise stated, will be payable to the Covered Person or to his estate.
How do I file a claim?
“Once you enroll, you can receive and complete our Insurance Claim Forms by calling our Claims Department where a representative would be glad to assist you in filing a claim.”
How long does it take to process my claim?
“After you file a claim, the carrier will make a decision to approve or deny your claim. If the carrier approves the claim, the insured person or beneficiary will be paid within 60 days of receiving complete proof of loss.”
ADDITIONAL QUESTIONS
What coverage is provided by this insurance? Is this Life insurance?
“This is Accidental Death and Dismemberment insurance which provides benefits in the event of loss of life, limb, sight, speech, or hearing as the result of a covered accident. While not life insurance, this is great supplemental coverage due to its low cost. Also, many life insurance policies require a medical exam prior to obtaining coverage. Accidental Death & Dismemberment insurance does not require an exam and acceptance is guaranteed.”
Can you remove me from your mailing list?
“Yes, we can. I’ll take care of that now and it will take 30 to 60 days to process. Please disregard any solicitations you receive during that time. You can also be removed from all mailing lists by calling the Direct Marketing Association at 212-768-7277 and you can register your phone number with donotcall.gov.”
Is this offer still available after 14 days?
“Yes, the offer is still available.
Is there an age cutoff?
“There is no age cutoff, however, benefits will be reduced by 50% at age 70 and reduces to 25% at age 75.”
Why is there an age reduction?
“The possibility of death due to an accident increases with age so the age reduction helps ensure rates don’t change over the life of the coverage.”
Does this policy have a cash value?
“No. There is no cash value for this insurance.”
What if I have other insurance?
“This insurance will pay all benefits due to a covered accident regardless of any other insurance you may have.”
Are on-the-job accidents covered?
“Yes. Your coverage is effective 24 hours a day, anywhere in the world.”
Who provides this insurance?
“Minnesota Life is the underwriter.”
Who is the plan administrator?
“Franklin Madison is the plan administrator.”
Who do you work for?
“I am employed by TLC & Associates.”