Timeline For Coverage of Critical Illness

A worker that has become injured might lack the ability to carry out his or her job responsibilities. The same consequence could result in a circumstance where an employee has contracted a critical illness.

First steps leading to coverage of a critical illness by an insurance company

One physician diagnoses the disease. A different doctor confirms that diagnosis. The insurance company mandates the completion of a survival period. In other words, the ill employee must survive for a set period, usually 30 days, before the claim gets accepted.

Introduction of the survival period helps to eliminate the chance that someone might try using critical illness coverage as a last-minute form of life insurance.

Provisions that relate to delivery of benefit

Once claim has been accepted, the claimant receives a lump sum benefit.
Before issuance of that lump sum, the insurance company creates a policy that is medically underwritten. The terms of the policy could change. Those terms are subject to offsets. That means that the size of the benefit could be reduced, if the policyholder were to gain access to additional benefits. The delivery of the promised benefits leads to termination of the insurance coverage.

Why it pays to make good use of the survival period

Personal Injury Lawyer in Amherst knows that because coverage terminates upon delivery of the lump sum payment, efforts should be made to obtain a payment that covers every eventuality. The person filing the claim should not assume that the illness could get treated. Instead, the person filing the claim needs to anticipate a continuation of the existing problems for an extended period of time.

The lump sum payment should cover all the known and anticipated costs. Could a deterioration of the patient’s condition lead to a demand for some special piece of equipment? If so, then that fact needs to be considered, when determining the size of an adequate payment. Frequently, the thought of obtaining a large sum of money tends to cloud the mind of the person that has been charged with making the claim for the ill individual. For that reason, a smart family takes the time to decide ahead of time how it plans to handle the anticipated funds.

The survival period provides families with a time for making such decisions. Ideally, any family group that cares about an ill relative should make good use of the survival period. The acquisition of a large amount of money does not carry with it any guarantee that the same amount of money will be well spent. As stated above, it is almost impossible to predict the length of time for which care must be given to the ill individual. Hence, it makes sense to plan for an ongoing effort.

More to explorer

Why It Pays To Settle Out-of-Court

Some claimants refuse to accept an offer that has been made by an insurance company, during an attempt at reaching a negotiated