Large Claim Information
BEST RE requires large claim information to underwrite.
Large claims are defined as follows:
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All Ongoing Claims AND
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Prior Shock Claims
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Social security number of claimant
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Age, sex and dependent status
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Total claims paid, pended, denied and processed to date
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Date of onset and date last claim received
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Diagnosis
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Prognosis
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Current status of claimant: active, disabled, terminated, retired or COBRA participant
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Any claim in excess of 50% of the lowest requested specific deductible for the last three years OR
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Any potential claim of a serious medical nature including but not limited to the Major Catastrophic conditions below.
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Renal Failure
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Major Organ Transplants (including stem cell or bone marrow)
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Heart Surgery
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Eating disorders (anorexia, bulimia)
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Diabetes
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Serious burns, (10% of the body with third degree or 20% of the body with second degree burns)
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HIV/AIDS and related conditions
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Serious Psychoneurotic Impairment
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Multiple or Serious Fractures
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Spinal Cord Injuries
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Premature birth or significant congenital defects
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Chronic Medical Conditions (requiring long term treatment or rehabilitation)
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Cerebral Vascular Accidents
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High Risk Pregnancies
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Head Traumas or Brain Injuries
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Amputations or permanent loss of limb(s)
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Chronic blood disorders
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Cancers
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Neonatal High Risk Infants
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Crushing or Massive Internal Injuries
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Hospitalizations of more than 15 days and multiple hospital confinements
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Loss of sight or hearing
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Infusion Therapies
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All other injuries or sickness which may, in the opinion of the administrator, reach the Specific Deductible
For Prior Shock Claims, we want to know the following:
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Amount of claim(s) and date(s) paid
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Current status of claimant; active, disabled, terminated, retired or COBRA participants
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