When should I notify YuLife of a potential claim?
We ask that we are notified of an absence as soon as possible. AIG like to be notified by week 5 of the absence so that they can consider whether early intervention via Proclaim Care would be appropriate to support a return to work prior to the claim commencement date. Some information about Proclaim Care can be found using this link:- https://aiglife.turtl.co/story/vocational-rehabilitation-proclaim-care/
When do I submit the claim forms?
AIG will forward the claim forms for completion when they have received notification and when it looks unlikely that the employee is going to return to work prior to the commencement date of the claim. This will normally be halfway through the deferred period but possibly earlier if a return to work seems unlikely. Claim forms should be returned directly to AIG.
Who needs to complete and sign the claim forms?
There are two claim forms to be completed.
Employer claim form to be completed by the employer and singed by someone on behalf of the employer (normally HR). Please ensure that the bank details noted on the claim form belong to the employer and not the employee as benefit will be paid to the employer.
Employee claim form can be completed by someone on behalf of the employee but it must be signed by the employee themselves as they are signing to confirm that the information provided is accurate, consenting to sharing information and also requesting information in relation to the claim.
What information should I submit along with the claim forms?
If the employee has been seen by occupational health or any doctor on behalf of the employer please forward any copies of medical reports you have along with the claim forms. It would also be helpful for us to be made aware of any performance issues or other work-related issues that may be contributing to the absence.
What happens when AIG receives the claim forms?
AIG will determine what medical evidence they need to request to help them assess the claim. In most cases this will be copies of General Practitioner’s records and any correspondence they hold in relation to their patient. During the assessment process they may request additional information from treating doctors and occasionally they may require the employee to attend an independent medical examination (IME). It is important that the employee understands that they do need to attend this if they are asked because it will impact the decision on the claim if they don’t. AIG would not normally be asking someone to attend an IME if there was any indication in the medical evidence that the were not fit to.
Who does the payment go to?
If the claim is accepted the payment will go to the employer and normally this is forwarded to the employee via payroll.
How long will it take to settle the claim?
Upon receipt of all the required information a decision will be made within 5 days and, if the claim is accepted, the payment will follow shortly afterwards.
How do I appeal if a claim is declined?
You should send an email to both email@example.com and firstname.lastname@example.org outlining the reason for the appeal and attaching any additional information. The claim will be reviewed by an appropriately qualified and experienced assessor at AIG who was not involved in the original claim decision. If the appeal process upholds the original decision contact details of the Financial Ombudsman Service will be provided.