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