Supplemental Claims Guide
Delivering on our promise means a lot to us at USAble Life and Benefit Services of Hawaii. Whether it’s an accident, an illness, or another life-changing event, we value our commitment to process and pay claims according to our insurance policies with the greatest care and integrity. You can feel secure in knowing that when you buy insurance from USAble Life, that’s exactly what you will get. It’s our assurance — our pledge — that we will be there for you.
Submitting a claim
Complete the claim form located in the claims download and submit to USAble Life in one of the following ways:
- Email: email@example.com
- Mail: P.O. Box 1650, Little Rock, AR 72203-1650
- Fax: Supplemental Claims to (501) 235.8416
- Fax: Wellness Claims to (501) 235.8400
Special instructions for wellness claims: Complete the wellness claim form located in the claims download, CL-Wellness (04-15), and follow the submission instructions above.
Documents needed to submit a claim
Claim forms for each product, in addition to the documents listed below, are required.
Accident and Hospital
- Itemized bills are needed to process a claim for medical expenses
- In lieu of a completed attending physician’s statement, the following may be acceptable:
- Emergency room report(s)
- Office visit note(s)
- Hospital admission and discharge summary
- Pathology report
- Itemized bills for medical expenses
- Specific claim form for the illness
- If you are unable to locate a claim form for the specific illness, use form CL-CI-Cancer (8-13) titled Cancer Certain Diseases Burns located in the claims download
A decision to pay, pend,* or deny a claim is reached on 95% of all claim submissions within five business days of receipt of claim.
Factors that increase claims processing time
- Medical record(s) and request(s)
- Premium status
- No beneficiary listed
- Minor beneficiary
- Manner/cause of death is pending
Appeals must be submitted in writing within 180 days of the claim decision.
Although not required, claimants may use the appeal form located in the claims download.
Appeal submissions can be sent in writing via mail, fax, or email, as noted below:
- Mail: USAble Life
Attn: Appeals Coordinator
P.O. Box 1650
Little Rock, AR 72203-1650
- Fax: (501) 235-8484
- Email: firstname.lastname@example.org
The appeal will include a new, comprehensive review of all documents and a determination by an individual who did not make the first claim decision.
Appeal decisions are made within 45-60 days of the appeal.
Inquiries regarding appeal status must be sent in writing to email@example.com.
*Pended claim: If the examiner needs information from an outside source (e.g., medical provider, employer), the information will be requested, and the claim will be put in a pended status for up to 45 days until the information is received. The response time for medical record(s) requests varies and may require an extension of the pended status.