Q: What information do I need to open a claim?
A: In order to file a claim, you need to have proof of your last day of work, your prior year W-2, and your doctor’s name, phone and fax number.
Q: How long will it be before I receive benefits?
A: Before your claim can be submitted to the insurance company, verification of your union status, proof of your last day worked and income verification need to be submitted to Cornerstone. Additionally, the claim cannot be processed by the insurance carrier until appropriate medical documentation is received from your treating physician verifying your disability. Once all required information is received, your claim will be submitted to the insurance carrier and they take approximately 10-14 business days to review before a decision is made and benefits would be paid. If your claim is subject to a pre-existing condition review, this review period will likely be extended depending on how quickly you doctor’s respond to requests from the insurance carrier.
Q: Will my claim be considered pre-existing?
A: If you have not satisfied your policy’s pre-existing condition limitations, the insurance carrier will conduct a pre-existing condition review. Cornerstone is not involved in determining whether or not a claim is pre-existing. It will be determined by the insurance carrier during the claim approval process and is based on your medical records. Please refer to your group policy booklet for further details.
Q: What if I am not able to verify the income I elected?
A: If your prior year W-2 or the 3 months of pay stubs leading up to your disability do not reflect the income you had elected during enrollment, your coverage elections will need to be adjusted. If you elected an option that pays a percentage of your income, your premiums will be lowered according to the income you are able to verify. If you elected a flat rate option, your income will not affect your premium amount. However, lowering your income may affect your offsets and the benefit amount you receive based on other group benefits available to you. If this is the case, your Cornerstone Claims Advocate will discuss your options this with you so there are no surprises when you receive your first disability payment.
Q: If I am going to be out longer than I was approved through, how do I get my claim extended?
A: In order to get a claim extended, additional medical documentation would be needed from your treating physician supporting continued disability. Please call our office at 847-387-3889 and speak to your Claims Advocate, who can send a request to your doctor for this information. Please note that a claim cannot be extended until sufficient medical documentation is received and reviewed by the insurance carrier. When new medical is sent to the insurance carrier, they can take up to 10 business days to review before a claim can be extended and additional benefits be paid.
Q: Do I still have to pay premiums while I am on disability?
A: While you are on Short Term Disability, the policy requires you continue to pay your monthly premiums. If you transition to Long Term Disability, or if you have not elected Long Term Disability and exhaust all available Short Term Disability benefits, your disability premiums will be waived. If you have life insurance, you are required to continue to pay those premiums and are able to keep the coverage for 12 months while on disability.
Q: If my doctor releases me to return to work, but my employer has not cleared my return, will my benefits continue?
A: Since your policy is designed to protect you while you are disabled, as soon as your doctor states you are no longer disabled, your benefits will cease. Sometimes your employer may need to complete their own release process in which you are no longer disabled, but are waiting on the completion of paperwork, a work physical, etc. This process is not covered by your disability benefits, so it is important that you and your physician coordinate your return to work process as smoothly as possible. Please contact your Claims Advocate at 847-387-3889 with any further questions or concerns regarding this matter.
Q: My claim has been denied; what are my next steps?
A: In the event that your disability claim is denied by the insurance carrier, you have the right to appeal their decision. Cornerstone offers a courtesy appeal service in which our appeals team will review your claim file to determine if we believe your claim was wrongfully denied. If Cornerstone agrees that your claim was wrongfully denied, our appeals specialist will write an appeal on your behalf. If your claim has been denied, please contact your Claims Advocate at 847-387-3889 so that they can help initiate this process.
Q: Who should I be contacting, Cornerstone or the insurance carrier?
A: To differentiate, Cornerstone is the administrator of your policy and the insurance carrier is the underwriter of the policy and the one who will approve and pay or deny claims. We recommend always contacting your Claims Advocate at Cornerstone with any questions or concerns to avoid any issues.