Excellerated death benifit questions

[richrlg]

I have an employer provided term life insurance policy that includes an accelerated death benefit rider. I just recently found out 2 important things. 1st I am being laid off and the policy will expire on Feb 28 and is convertible to a permanent policy, but without the rider. 2nd, that I have metastatic melanoma of the lung and brain. Although there are new promising treatments, the disease is still considered terminal, and I have already had a complication resulting in a brain tumor removal. So I have submitted the claim for the accelerated benefit while the current policy is still in force. My doctor has put my life expectancy on the claim at 12 months which meets the policy criteria. My concern is how is whether or not the company has to follow the current policy rider once the policy expires if they have not made a determination by its end date or if they deny and, I have to fight it legally, does it still get judged on the status of the policy at the time of the claim?
My last concern is of the life expectancy. How difficult is it for them to say that because of new treatments the average melanoma patience is living 16 months and not 12 months - so he does not meet the criterial?I will convert the policy regardless and it will eventually be collected on but the accelerated funds would be a help since I may or may not be able to return to work. All input is appreciated.​

 

[DHK]

You are employed and covered by the policy at the time of a qualified diagnosis. Everything is dated and should be "cut and dried" simple.

My only suggested recommendation would be to get ANOTHER diagnosis to back it up "for insurance purposes".

Obviously this is not legal advice, but I think it would make sense.

 

[jcorr]

Will the policy actually expire? Or is the original term up and you'll just have to pay a higher premium? Does the policy have a waiver of premium rider on it?

 

[richrlg]

It is an employee benefit policy paid for by my company. The company closed my division and I was laid off and benefits carry through 2/28/2019. The policy is convertible to a UL policy in which I have to pay for out of pocket. Which is ok, but it specifically states that the converted policy does not contain the accelerated death benefit rider. Does not have a waiver of premium rider.

 

[glgamerica]

Your best source of information is to ask the insurance company what you should do. Since your question isn't very common, it's possible you might not get a direct answer.

To protect your interests, I would go ahead and convert the policy if you don't have a decision by the deadline regardless of what they might tell you. If your claim is denied for any reason, then you won't miss out on the conversion. If your claim is approved, then you'll most likely get back the money you paid for the conversion and you won't have the converted policy.

It's not a surprise that neither accelerated death benefit nor waiver of premium carry over to the converted policy. Most group term life conversions are requested by people who are uninsurable and since the insurance companies know this, it's to limit their risk.

If your doctors records meet the guidelines that classify your condition as terminal at the time of claim, then that's all that matters to the insurance company. If you live longer than the doctor thinks or recover completely, once the claim is paid out, none of that matters.

I once had a policyholder who got a liver transplant after accelerating their benefit which helped them live a lot longer.

I wrote an article a few days ago about the terminal illness rider for additional reference.
https://www.glgamerica.com/terminal-illness-rider/

Best of luck to you.