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: under 19, or under 25 if enrolled as a full-time student at an Institution of Higher Learning; or classified as an Incapacitated Dependent Child
- No termination age; however, coverage reduces by 35% at age 70 or older
BENEFITS
- Complimentary coverage of $1,000 paid by Fingerhut
- Offers up to $300,000 of supplemental coverage elected and paid by the primary insured
- Benefits double if loss of life occurs when traveling by common carrier
- Individual or Family coverage available
FAMILY COVERAGE PERCENTAGES
- Spouse – 60% supplemental coverage amount
- Child(ren): Each dependent child – 25% supplemental coverage amount
ADD ON BENEFITS:
- You only need to read the description for the benefit being asked about
“You automatically receive the following benefits when you select added coverage:
Common Carrier – This benefit provides benefits for accidental loss of life from a covered injury while traveling as a passenger in or on a public conveyance operated by a licensed common carrier. Benefit is two times the amount of the supplemental coverage.
Education Expense Benefit – If the Insured Person suffers Accidental Loss of Life, this benefit will reimburse actual incurred costs for an eligible Dependent Child(ren)’s tuition, fees, room and board, required books and course supplies billed by an institution of higher learning. This benefit pays for each eligible Dependent Child who is enrolled at, or subsequently enrolls as a full-time student at an institution of higher learning within 2 years of the Loss of Life. This benefit will reimburse up to 2% of the Principal Sum annually for each eligible child for up to four (4) consecutive years. The maximum annual benefit is $50,000. If there are no eligible Dependent Children, a one-time payment of $2,000 will be paid.
Home Alteration or Vehicle Modification – Reimburses the insured for expenses to alter a home or modify a vehicle to accommodate a physical disability as a result of a covered accident.
Enhanced In-Hospital – Provides coverage for each day the insured is in the hospital due to a covered accident but not more than the maximum number of days allowable. This benefit is payable in addition to any other applicable benefit amounts and will be paid until the earliest of the date the insured dies, or is no longer in the hospital, or the maximum number of days has elapsed. If the injured is discharged from the hospital and returns within 3 days after discharge, then any time in the hospital will count to satisfy the elimination period.
Please refer to your Summary of Insurance, or once insured, your Insurance Coverage Document for specific details.”
What is a common carrier?
“Common Carrier means any motorized land, water or air conveyance licensed for the transportation of passengers for hire and operated by an employee or an individual under contract. For example, commercial airlines, trains, buses, cabs, ferries. Common Carrier does not include any conveyance used for recreational activities.”
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
Both my husband and I have our names on this letter. Can we both sign up for complimentary insurance?
“Complimentary coverage will be enrolled as the Account holder who signs the form. Additional family coverage can be purchased for both husband and wife to be covered.”
What does dependent child mean? Are my grandchildren covered?
“The primary insured person’s unmarried child from the moment of birth, including natural child, grandchild, stepchild or adopted child from the date of placement with a primary insured person.”
Can my handicapped child be covered?
“The definition of a covered child is determined by the state the coverage is written under, but the child must be financially dependent on the insured. The final determination is made by the insurance company once a claim is filed.”
How do I assign more than one beneficiary?
“You can name as many beneficiaries as you would like by either writing your additional beneficiaries on the back of your enrollment form, or adding an additional piece of paper to the envelope when you mail in your 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 can choose $50,000, $100,000, $150,000, or $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?
“Spouses and unmarried dependent children may be insured under the family plan. If you choose the family plan, spouses are insured for 60% of your additional coverage amount. Dependent children are each insured for 25%.
Who is covered under the family plan?
“The Family Plan would provide coverage for yourself, your spouse 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?
“No medical exams, blood tests, health questions are required to get and keep this coverage.”
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.”
When will I be billed?
“Your billing schedule will be shown on your certificate of insurance that you will receive within 15 days of your activation. Please note that your effective and billing dates may be delayed depending on the billing cycle of your financial institution.”
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?
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- Benefits for dismemberment loss of the Primary Insured; or loss of life of covered dependents (family coverage), will be paid to the Primary Insured. If no beneficiary is designated or alive when the Primary Insured dies, benefits for loss of life will be paid to the first surviving party in the following order:
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- Spouse
- In equal shares to the surviving children
- In equal shares to the surviving parents
- In equal shares to the surviving brothers and sisters
- Primary Insured’s estate
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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?
“For all benefits payable under the policy, the insurer will pay the insured person or beneficiary the applicable benefit amount 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? Whose age is the reduction based on?
“There is no termination age; however, all coverage is reduced by 35% at age 70. The age reduction is based on the age of the primary insured at the time of claim. Age reduction is only applied (even to the spouse and dependents) if the primary insured is over the age of 70.”
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?
“Federal Insurance Company, a Chubb company, 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] / [InteLogix].”