Life Insurance

 

Life Insurance

Making a Life Insurance Claim

1. All life insurance claims must be processed through the Health and Life Insurance Section at Headquarters. Claims or notification of claims should not be transmitted to the Aetna Life Insurance Company directly.

2. The claim process is initiated when the Health and Life Insurance Section is informed about the death of a participant in the group life insurance programme or when all applicable claim documents, as set out in paragraph 3 below, are received along with notification of death. In the former case, in order to permit the insurer, Aetna, to pay the requisite benefits, the Section will provide the beneficiaries with clear instructions regarding the documents that must be completed and submitted. In the latter case, the Section will forward the properly furnished set of claim documents to Aetna for processing.

3. The claim package, with translations into English as necessary, consists of:
(a) Records of life insurance participation, if not previously submitted to the Health and Life Insurance Section to establish an ASLI entitlement. These records are maintained by the Organization and are not the responsibility of the claimant to furnish;
(b) The original or a legally certified copy of the insured's death certificate (a death certificate furnished to the United Nations Joint Staff Pension Fund will not suffice for life insurance purposes);
(c) Official medical certification as to the cause of death when not stated on the death certificate;
(d) Completed United Nations group life insurance programme beneficiary certification forms. As the Aetna group life insurance plan is United States-based and subject to its federal and state regulations, either form 1 or form 2, whichever is applicable, is to be completed by each beneficiary.
(e) Additional documentation will be required in the following circumstances:
(i) Where a beneficiary is deceased, a copy of the beneficiary's death certificate. If all beneficiaries are deceased, evidence of the legally recognized appointment of the person designated to administer the assets/property ("estate" under United States law) of the insured. Or, should any beneficiary die after the insured but before a claim is paid, court papers appointing a person to administer the "estate" of that beneficiary. Should there be no corresponding legal concept under applicable national laws, proceeds will be paid to the ESTATE of the insured (or of the beneficiary) and those closest to the deceased may seek documents under their national law governing the line of legal succession, permitting a bank to accept a deposit of a benefit cheque. In this regard, beneficiary instructions in paragraphs 25 to 27 of the current circular should be noted;
(ii) Where beneficiaries have not reached the age of majority, the legally recognized appointment of the guardian of the "estate" (assets/property) of the minor child. Where such guardian is a surviving parent living outside the United States, a copy of the national law governing minor children, stating that the surviving parent automatically becomes the guardian of the property of a minor child and setting out the age of majority, along with a copy of the child's birth certificate establishing the names of the father and the mother, may be submitted in lieu of court papers. Oaths sworn before a notary do not satisfy the requirements of Aetna's legal department;
(iii) Where death may be considered accidental, the official police report, setting out the circumstances that resulted in the death of the insured (inter alia, the time of day, weather conditions, testimony of eyewitnesses, diagrams) and any autopsy statement/medical report;
(iv) Where death occurs within two years of the approval date indicated on an evidence of insurability statement, all medical records for the previous five years.

4. Staff members should be aware that the life insurance principal (the full amount of coverage regardless of how it is distributed among beneficiaries) is exempt from all United States taxes. The tax exemption may not apply if life insurance proceeds are paid to an estate that is subject to United States taxes.

5. Life insurance benefits, upon the death of the insured, earn interest at a rate determined by Aetna until the date on which proceeds are paid to beneficiaries. Unlike the life insurance proceeds, interest earned may be subject to taxation.

6. Beneficiaries should be aware that, as the United Nations group life insurance plan is a global programme administered on a highly decentralized basis, gathering together all the documentation and records required to process a claim can take some time. Once the Health and Life Insurance Section receives all necessary documentation, properly executed, and submits the claim package to Aetna, it normally takes three to four weeks before the beneficiary is in receipt of the life insurance proceeds. Each beneficiary will receive an individual cheque (principal amount plus interest earned) by a secure mode of delivery. Aetna benefit cheques have no expiry date. It should be noted that Aetna does not deposit benefit proceeds directly into bank accounts.

7. Group life insurance participants may wish to note that there is no prescribed time frame for submitting claims.