When you file a Transamerica Critical Illness claim they ask for a very brief Claim form to be completed and submitted. Upon reviewing the form, medical records and a Doctor’s Statement, the insurer will decide if a claim offer is justified.
In order for a Transamerica critical illness claim to be considered the insured must have a Covered Condition, have a Policy in good standing, and the Benefit Calculation must have a net positive result.
Very little help is offered by the insurer to complete the Claim form or evaluate the accuracy of a benefit offer. We’re experts at both and represent anyone with a critical illness claim to ensure fair treatment and maximum payout offers.
If you need help with a Transamerica Critical Illness Claim, go Here.
Critical Illness Insurance
A Critical Illness Benefit is a Rider to a life insurance policy that allows the policyowner to receive part of their death benefit while they are still alive if they’re diagnosed with an illness that is covered by the Rider. A Critical Illness Rider is a supplemental benefit — or an add-on — usually to a life insurance policy. They’re also known as Living Benefits. Many of the largest life insurers in the US offer Living Benefit riders to their life insurance policies.
When a policyholder has been diagnosed with a critical illness they can make a claim against some portion of the death benefit of their life insurance. If the claim is approved they’ll receive the money while they’re still alive.
Step-by-Step Guide to File a Transamerica Critical illness Claim
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Review the Terms & Conditions of your Policy.
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Confirm that your illness is a Covered Condition.
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Contact the Claims Department and request the Claim forms.
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Inform your doctor you will need a written statement about your condition.
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Submit the Claim forms and Physician’s Statement to Transamerica.
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Send us the Offer for review before accepting.
Transamerica Critical Illness Claim Form
The Claim form asks for basic information about the insured such as name, address, and policy number. It also asks when the person was diagnosed with their condition and who the treating doctor is. There are medical conditions listed, and the insured will check one next to their condition.
Note: It’s much better to write out a description of the insured’s diagnosis with as much detail as possible and attach it to the claim form. This helps to ensure the claim examiner doesn’t make any wrong conclusions about the medical condition.
The most important part of the Critical Illness claim form is the Attending Physician’s Statement. This is to be completed by the doctor who is treating the insured.
Warning: The doctor doesn’t know what Conditions are in the policy for any critical illness. For example, the doctor doesn’t know that for a Stroke claim to be approved specific imaging tests have to have been completed and evaluated in writing. Therefore, simply acknowledging the insured had a “stroke” won’t be enough to get the claim paid.
Doctors are busy professionals and they aren’t likely to spend time making sure they meet the reporting requirements of a life insurer when the complete the Attending Physician’s Statement. That’s why it’s so vital to have your own claim representative who knows what the policy says, what the insurer wants, and works with the treating doctor directly.
Common Reasons a Transamerica Critical Illness Claim is Denied
- The medical Condition isn’t a Covered Condition of the Policy.
- The Insured’s medical records are incomplete.
- Disagreements over Policy definitions.
- The Policy wasn’t in effect when the medical Condition was diagnosed.
Help with a Transamerica Critical Illness Claim
The first step to resolving a dispute over a critical illness claim is to engage a critical illness Claim Expert. This isn’t an attorney or insurance agent, but rather it’s a firm with specific knowledge and experience with critical illness claims. The method of claim evaluation should be investigated, the language of the Policy, and the underwriting processes of the insurer. Then, a sound plan of rebuttal can be made with a successful outcome for the insured.
Contact us to discuss your claim.
Read:
Critical Illness Claim Patient Advocate
Chronic Illness and Critical Illness Insurance Claims
Complaints About Transamerica Life Insurance
The Center for Life Insurance Disputes. Copyright 10.26.2020
