Insurance Claims

Plan pays a monthly amount from $700 to $2,000, for 90 days up to 2 years when you are totally disabled due to a non-work related injury/illness only

1. Notice of Claim: Send a written notice of claim to Assurity office within 20 days after the occurrence of your off-the-job injury or illness, or as soon as reasonably possible.
2. Complete the first page of the Assurity Claim Forms & Assurity's Authorization For Release of Information Form. Send the second page of the form to your payroll/personnel office, and then to your attending physician.
3. If your disability started within the 2 first years of the policy, the insurance company will request your medical records for the two last years. If you have Kaiser Permanente, please complete the Kaiser Authorization for Release of Information Form.
4. These forms must be returned to Assurity At Work within 90 days after the termination of the period for which the insurer is liable.

Do You Have Your Forms Yet?

1. Only Non-work related illness or injury are covered.
2. Pre-esisting Condition Limitation Clause: Assurity does not cover pre-existing conditions for the first 2 years after the effective date of the coverage.
   
   Exceptions:
   1. When pre-existing condition is disclosed in the application, Assurity does not cover pre-existing conditions for only 1 year after the effective date of the policy.
   2. If you are age 65 and over, Assurity does not cover pre-existing conditions for the first 6 months after the effective date of the coverage.
3. Pre-esisting Condition Investigation: If your disability starts within the first 2 years of the effective date of your policy, Assurity will conduct a Pre-existing Condition Investigation. Assurity will request your medical records for 2 years prior your effective date to check if you have a pre-existing condition. If your health provider is Kaiser, please note that Kaiser takes at least 1 month to provide the medical records.