Life Details
Death Benefit provision. Payment of an Accelerated Death Benefit for one Insured will not reduce any other Insured's life insurance coverage and will not reduce accidental death and dismemberment insurance coverage. Any Life Benefit Amount that would be continued under a disability continuation provision or that may be available under Conversion will be reduced by the amount of the Accelerated Death Benefit paid. The remaining Life Benefit Amount will be paid in accordance with the provisions of this certificate. Upon request to accelerate an Insured's Death Benefit and upon the payment of the Accelerated Death Benefit, we will provide a statement to the Insured and any assignee of record or irrevocable beneficiary of record demonstrating the effect of the acceleration on the Insured's Death Benefit. Upon payment of the Accelerated Death Benefit, the certificate will remain in force, unless coverage terminates. Premium payments must continue to be paid on the full amount of an Insured's life insurance coverage in force prior to the payment of the Insured's Accelerated Death Benefit unless the Insured is approved to have life premium waived in accordance with the Waiver of Premium section of this certificate. Applying for an Accelerated Death Benefit This replaces the Filing a Claim provision in the Claim Provisions section of this certificate. If there are any questions on how to file a claim, please contact us or your Employer. Starting a Claim Notice of a claim may be provided in Writing, online at: services.unum.com, or by contacting us directly at 1-800-635-5597. Completed claim forms may be submitted online or sent to us by mail, or fax: Mailing Address: The Benefits Center P.O. Box 100158 Columbia, South Carolina 29202-3158 Fax: (800) 447-2498 Proof of Loss Proof of Loss must be sent to us no later than 90 days after the date the claim is filed for an Accelerated Death Benefit. If it is not reasonably possible to provide Proof of Loss within this time period, it will not affect a Payable Claim if it is provided within one year, unless the Insured lacks the legal capacity to do so. In no event can Proof of Loss be submitted after the expiration of the time limit for commencing Legal Action as stated in this certificate, even if the failure to provide Proof of Loss is due to a lack of legal capacity or if state law provides an exception to the one year time period. Proof of Loss provided at your or your authorized representative's expense, must include, but not be limited to the following: - satisfactory Written proof from the Insured's Physician certifying that the Insured is Terminally Ill; and - the appropriate documentation of your financial records, including but not limited to, Earnings and income tax returns. If the Proof of Loss is not complete, we will request additional information.
UA-GTLC21-1
Group Life and Accidental Death and Dismemberment Certificate
(1/1/2025) 7
Unum Life Insurance Company of America
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