APA POD CLAIMS PROCESSING PROVISIONS
Claims Filing
Plan Participants are required to file a completed claim form when applying for benefits. Failure to provide complete and accurate information on the claim form may unnecessarily delay claim processing.
Time Limit For Filing A Claim
A Plan Participant must file written proof of a claim with Harvey Watt. A Plan Participant should file a claim as soon as possible because delayed filing can lead to a delay in the start of benefit payments or a denial of benefit payments. The following time limits apply to all claims unless the Plan Participant can show that it was not within his reasonable control to file a claim and that he Filed the claim as soon as was reasonable possible.
- Claims Filed within six months of the Onset of Disability will be payable on the later of: (1) the first day of the month coincident with or next following the day that is 14 months after the Onset of Disability; or (2) the day following the exhaustion of paid sick and vacation time from the Company.
- Claims Filed more than six months after the Onset of Disability will be payable on the day after the later of: (1) 12 months from the date Filed; or (2) the exhaustion of paid sick and vacation time from the Company.
- Claims will not be eligible for payment if Filed after the later of: (1) more than 24 months after the Onset of Disability; or (2) the exhaustion of paid sick and vacation time from the Company.
For examples please refer to pages 28 & 29 of the POD Plan Document
A Plan Participant who has a Recurrent Disability must file a claim for benefits by the Recurrent Disability Filing Deadline to avoid a delay in the payment (see the "Payment Period" subsection on page 17 for more information.).
If coverage ceases due to termination of the Plan, final claims must, without exception, be received within 90 days following the effective date of termination of the Plan. Claims will be paid from available Plan assets upon the Plan Participant's qualification for Disability benefits.
This summary provides a brief explanation of the major provisions of this benefit plan. It is not a detailed description. The actual plan document and summary plan description contain a complete description of the benefit plans offered and rights under the plan. If there is any conflict between this summary and the plan document, the terms of the plan document governs.
Please contact Octavia Wooten for more information or questions on filing a claim.
Owooten@harveywatt.com or 800-241-6103 ext 236