Voya Claims 360
Helping employees use the Supplemental Health benefits they’re enrolled in
Voya Claims 360 is an integrated and intuitive model designed to simplify the claims process for Supplemental Health Insurance products.
From the time an employee enrolls to when a claim is processed and paid, Voya Claims 360 kicks off a variety of proactive actions to help employees get the most from their benefits.
Support ranges from connecting the dots between coverages and notifying employees when they have a potential benefit opportunity, to even paying benefits for certain covered events automatically. The goal of Voya Claims 360? Simplify and streamline the process for employees.
Simplified claims come full circle
Using this integrated model, Voya Claims 360 includes product-to-product claims integration, intuitive claims payment, medical claims integration and an auto-pay claims process — where we may even pay a benefit automatically. Claims 360 also includes:
Employees enrolled in Accident Insurance or Hospital Indemnity Insurance can file a claim online without having to print and sign forms to upload. Also available for Wellness Benefit claims.
Online claims center
For all of our products, our straightforward claims submission process guides employees through the claims process from the submittal through a claims decision.
Get more details about Voya Claims 360:
The results speak for themselves
In 2021, Voya Claims 360 claim integration processes resulted in $782,488 in paid eligible benefits across 377 claims.
- $328,834 were paid automatically through the Short Term Disability (STD)-to-Accident and STD-to-Critical Illness auto-pay processes*
- $453,654 were paid from claims initiated by the claimant after receiving a reminder from Voya to file a claim.*
*Based on internal claims data January 2021 - December 2021: $328,834 - combined total Accident or Critical Illness Insurance benefits paid using the STD-to-Accident Insurance or STD-to-Critical Illness Insurance Auto-Pay claims process, 79 claims; $270,799 - combined total benefits paid after the claimant received an email reminder to file a claim using the Medical Claim Integration process March - December 2021, 220 claims; $182,855 - combined total benefits paid after a claimant received an email reminder to file a claim, 78 claims. Average Accident Insurance claim paid in 2021: $1,053; average Hospital Indemnity Insurance claim paid in 2021: $1,557; and average Critical Illness/Specified Disease Insurance claim paid in 2021: $10,612. Results may vary.
Voya Claims 360 in action
Here are two real-life examples of how Claims 360 helps employees use their Supplemental Health benefits:
Jacob’s Claims 360 story
Jacob* took a bad fall at home and went to the emergency room
So, he submitted a Hospital Indemnity Insurance claim. A review of his claim and supporting documentation showed that Jacob fell accidentally and hit his head, which resulted in a concussion and some knee pain.
We then were able to see that he also had Accident Insurance — but he hadn’t filed a claim. As we processed the Hospital Indemnity claim we also opened an Accident claim. While we may sometimes notify an insured of an opportunity to file a claim, in this situation, no additional action was needed on Jacob’s part.
Jacob received eligible paid benefits under his Hospital Indemnity and Accident Insurance. While he hadn’t thought to file an Accident claim, our claims integration process enabled us to make sure he was receiving the benefits for which he was eligible under all of his active coverage.
He was able to recover comfortably at home — and the benefits he received helped lessen the financial impact of the accident on his budget.
*Name changed. Hospital Indemnity and Accident Insurance are limited benefit policies. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. “Hospital” is specifically defined in the certificate of insurance. This is an example that is based on an actual 2022 paid claim that utilized the HI-Accident claims integration process. It is provided for illustrative purposes only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. Actual results may vary.
Carrie’s Claims 360 story
Carrie* had a heart attack and ended up in the hospital for a few days
She had Critical Illness Insurance, but at the time the claim was filed, we did not have enough records to support the Critical Illness claim. So, we pended it for additional medical records.
However, during our review, we saw that she also had Hospital Indemnity Insurance. The records we did have confirmed a three-day hospitalization — and that met the definition of a covered hospitalization under the provisions of her coverage. A Hospital Indemnity claim was opened automatically and approved for payment.
A week later, we received the additional information we needed that confirmed the diagnosis of a heart attack. We were then able to process the Critical Illness claim for benefit payment.
Carrie was able to recover comfortably at home — and the benefits she received minimized the financial impact of the out-of-pocket expenses she experienced due to her heart attack.
*Name changed. Critical Illness and Hospital Indemnity Insurance are limited benefit policies. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. This is an example that is based on an actual 2022 paid claim that utilized the claims integration process. It is provided for illustrative purposes only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. Actual results may vary.
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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. To keep coverage in force, premiums are payable up to the date of coverage termination. 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.