Pete’s Claims 360 Story
Pete* was injured in a motorcycle accident
As a result, the injuries to his leg prevented him from working for several months. He filed a Short Term Disability Income Insurance claim, which included more information about what had happened, and the details were passed along for review as part of the Claims 360 STD-to-Accident Auto-Pay integration.
When the claims examiner, Anna*, reviewed Pete’s case, it stood out. “I saw it was a motorcycle accident, and it struck a different chord,” she said. “My father is a motorcycle rider as well, so these types of claims always stand out.”
As Anna dug deeper, she could see that Pete was eligible for benefits he hadn't yet received under his Accident Insurance coverage. She could also see he was covered by Hospital Indemnity Insurance and had been hospitalized for his injuries, but had not yet filed a claim. Anna opened these claims on his behalf, and gave Pete a call.
“As I began talking to him, I could just hear the relief in his voice,” Anna said. “He was experiencing some financial challenges, so I could tell the payments were coming at a time he really needed it.”
Pete received an Accident Insurance benefit payment of $11,565 and a Hospital Indemnity Insurance benefit payment of $1,800 for the covered events he experienced
Because these are supplemental benefits that are paid directly to him, he has been able to use them however he’d like.
“It’s so gratifying to be able to give someone a little bit of light at the end of the tunnel,” Anna said. “I let him know that we’re here and we’ve got his back, and I just kept reiterating that he could receive benefits in the future for events covered by his insurance like follow-up visits or physical therapy.”
“I’ve talked to him a couple of times since that initial phone call to go over ways to get documentation to me for other parts of this claim,” Anna continued. “It feels amazing to be able to do this — to provide something that for some, depending on their situation, can be life changing. I love being able to help people like that.”
Pete’s integrated claim process included three Voya-offered products:
*Names changed.
**Medical claims integration is available for Accident Insurance, Critical Illness/Specified Disease Insurance, or Hospital Confinement Indemnity Insurance offered by Voya Employee Benefits. These are not coordinated benefits and medical coverage is not offered by Voya Employee Benefits.
***Formless submissions are currently available for Wellness benefit, Accident Insurance and Hospital Indemnity Insurance claims.
This example is based on an actual 2020 claim that utilized product-to-product claims integration. It is provided for illustrative purposes only. The average Accident Insurance benefit amount paid in 2020 was $1,100. The average Hospital Confinement Indemnity Insurance benefit amount paid in 2020 was $1,500. Filing a claim may require any necessary medical records or proof of claim as determined during the review process.
A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. All coverage is subject to the terms and conditions of the group policy. If there is any discrepancy between this document and the group policy documents, the policy documents will govern.
Insurance products are issued by ReliaStar Life Insurance Company (Minneapolis, MN) and ReliaStar Life Insurance Company of New York (Woodbury, NY). Within the State of New York, only ReliaStar Life Insurance Company of New York is admitted, and its products issued. Both are members of the Voya® family of companies. Voya Employee Benefits is a division of both companies. Product availability and specific provisions may vary by state and employer’s plan.