What is considered accidental dismemberment?
Dismemberment is the loss of one or more of the following due to an Accidental Bodily Injury: your hand by actual severance through or above the wrist; loss of your foot by actual severance through or above the ankle joint; and loss of your sight in one eye resulting in total and permanent loss of vision that cannot be recovered by surgery or other means.
How do I file a dismemberment claim?
Within 120 days of an accident, a completed dismemberment benefits claim form is required. All claim forms require information to be provided by three parties: the insured employee, the benefits coordinator, and the attending practitioner. You must complete identifying information in the Employee's Statement and forward the form to your benefits coordinator who will complete the Employer's Statement and return the form to you. When you receive the form, have your doctor complete the Attending Practitioner's Statement. Then, complete, sign, and date the claim form and forward with all attachments to Dearborn National at the address shown on the claim form. Dearborn National must receive your claim form within 18 months of the Accidental Bodily Injury.
What is needed when the death is considered an accident?
When the death may be the result of an accident, additional documents are required. Such additional documents may include one or more of the following: Department of Public Safety accident report, police or incident report, autopsy report, toxicology report, medical records, etc. Other investigative reports may be required based on the specific circumstances regarding the death. Dearborn National will provide you with specific instructions on additional documentation.
How much will I receive for dismemberment benefits?
For the loss of one qualifying bodily member, 50% of the eligible benefit; for two or more qualifying bodily members 100% of the eligible benefit. The maximum payable from one accident resulting in the loss of life and/or qualifying bodily members is 100% of the eligible benefit.
How long will it take to process my claim check?
Dismemberment claims generally require additional documentation such as medical records, police or incident reports, etc. Benefits are issued within 10 days following receipt of all required documentation and approval by Dearborn National. To check the status, contact Dearborn National Customer Service at 1-855-ERS-LIFE (1-855-377-5433).
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