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Frequently Asked Questions for Critical Illness, Chronic Illness or Terminal Illness Claims

  • A claim form completed and signed by the policy owner and certifying physician. The appropriate claim form will be sent to you after you initiate the claim online. Please make sure all sections of the claim form are completed and signed, including the HIPAA authorization. Note that one section must be completed and signed by the treating physician (or licensed healthcare practitioner) who diagnosed or certified the illness/condition for which the claim is being filed. This section is clearly marked on the form.
  • Supporting medical documentation is also required. Our Claims team will obtain any supporting documentation or records that are not submitted with the claim.
  • If the policy has an irrevocable beneficiary(ies), their consent is also required.
  • If the policy owner is a trust, a Certification of Trust will be included in the claim packet, and must be signed by the trustee and returned with the claim form.

The insured’s Power of Attorney can sign the insured’s name on the form. A copy of the Power of Attorney will also be required.

Review your policy’s rider and its terms. If the rider’s name includes “Accelerated Death Benefit,” it may require that a claim be filed within either 365 days or 12 months after the condition is certified by a physician.

  • For critical and chronic illnesses, some policies require that the rider be “in force” (meaning, it has been paid and active) for at least 30 days before the rider coverage is available. If a critical or chronic condition is certified during this 30-day period, a claim may not qualify for benefits. Terminal illness riders do not have a waiting period.
  • Most chronic  illness riders also have an “elimination period” of 90 consecutive days. This means that the insured must have a qualifying chronic illness for 90 consecutive days before they are eligible for benefits under the rider. 

Review your policy’s rider. Some riders state the amount of the benefit available up to a maximum amount. Other riders indicate the benefit amount will be calculated by the Company and will be determined when the claim is approved. If you still have questions, contact Customer Service for additional information.

The physician certification must be signed by a U.S.-licensed physician practicing in the state (or U.S. territory) where the physician is licensed. U.S. states and territories include the District of Columbia, Puerto Rico, the U.S. Virgin Islands and Guam. A claim certified by a U.S.-licensed physician practicing outside these U.S. states and territories is not acceptable.

It depends on the policy type, so check your policy documents. In most cases, policy owners have a one-time opportunity to file for the same illness under both the Critical Illness Accelerated Benefit Rider and the Chronic Illness Accelerated Benefit Rider. 

It depends on the type of policy and rider, so check your policy and verify the name of your rider. If the rider’s name includes “Accelerated Death Benefit”:
 

  • For term policies, the premium will change if a portion of the total benefit is taken. If the full benefit is used, the term policy will be terminated.
  • For Universal Life Policies or Interest-Indexed Policies, the policy owner will need to contact Customer Service to select a new premium amount. These types of policies have flexible premiums which are determined by the policy owner within minimum and maximum guidelines.

Deferred premiums are accrued by the Company and added to a lien on each anniversary date of their policy. Deferred premiums are prorated if a death claim is received prior to an anniversary date.

Yes. If you want to receive a benefit by wire or EFT, you will need to provide a voided copy of a check to confirm the routing code and bank account number. Out-of-country wire transfers will require additional information such as an intermediary bank, which may require additional time to process the payment.

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