Claims Practices of Voluntary Carriers

Cost: $2,500; published 2018

We all know well-designed voluntary products and effective enrollment capabilities are important for helping make the sale on the front end. But to keep the business, brokers and employers must have confidence in the carrier’s administration and service capabilities, especially when the “rubber meets the road” and a claim needs to be paid. Easy claims processes, good communication, quick turnaround and accuracy of claims payments, regardless of product, are essential to creating and growing market share and supporting your brand.

The purpose of the Claims Practices of Voluntary Carriers Spotlightâ„¢ Report is to provide information, by carrier, on key claims practices including:

  • Claims area structure
  • Claims filing and status capabilities
  • Claims time standards by product
  • Express-pay claims services
  • Claims process integration across product lines
  • Claims evaluation and tracking
  • Concerns, obstacles and future trends

With this information, carriers have a source for comparing their own claim practices with competitors and can plan for the future based on the trends and expectations expressed by those surveyed.

View Table of Contents

1. Executive Summary

A. Report Objectives

B. Methodology

C. Key Findings

2. Findings by Carrier

A. Carrier Data

1. Product Platform Offered

2. Separate Voluntary/Worksite Claims Area

3. Claims Structure and Organization

4. Outsourcing of Claims

B. Claims Filing and Status Capabilities

1. Ways to File a Claim

2. Notifications to Claimants

3. Claims Status Tracking Methods

4. Follow-Ups to Claimants for More Information

5. Claims Tracking for Brokers/Employers

C. Claims Standards and Processes

1. Time Standards - Regular and Complex Claims

2. Time Standard Measurement

3. Complex Claims

4. Express Claims Payment

5. Pre-Payment of Disability Claims

6. Claims During the Pre-Existing Exclusion Period

7. Wellness Claims

8. Employer Verification of Claims

9. Claims for Multiple Products

10.Support for Non-English Speaking Claimants

D. Claims Evaluation and Tracking

1.Phone Call Standards

2.Percentange of Claims Submitted by Method

3.Auto-Adjudicated Claims

4.Claims Settled in 10 Days

5.Claims Satisfaction Surveys

6.Other Claims Performance Measures

E. Claims Concerns/Obstacles/Trends




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