CLHIA-ACCAP - Consumer Information

A guide to life insurance

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34 WHAT IT'S ALL ABOUT: PAYMENT OF THE CLAIM It is the responsibility of the beneficiary or his/her representative to set the wheels in motion to file a claim. In most cases, a claimant's statement on a form provided by the insurance compa- ny, and proof of death, doctor's statement or death certificate are all that's required. What documentation is needed? Life insurance companies are dedicated to considerate and prompt payment of death claims. Efforts are continually made to speed up the process. Payment can usually be expected within a week to 10 days of presenting the insurance company with full documentation. However, there are some circumstances that can slow down the process (e.g., if the cause of death requires investigation, or if death occurs within the "contestable" period). How long does it take? It means that the insurance company has the legal right, during the first two years of the policy, to contest its validity on the grounds that information material to the risk has been held back or misrepresented. If it has been, the policy can be voided and premiums returned. If there is a death during this twoyear period, there may be inquiries that could result in a delay in the payment of the claim, or even in its denial. After the policy is in force for two years, the company cannot contest it except in the case of fraud, that is, a deliberate misstatement of fact. An example of fraud is a smoker who declares himself/herself as a non-smoker in order to get a reduced premium. What does "contestable" mean?

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