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U.S. Department of Labor Announces Denials of Life Claims Due Solely to Lack of EOI Are Banned

In a recent settlement with Prudential, the U.S. Department of Labor barred denials of employer-paid life claims due to lack of evidence of insurability after 90 days of paid premiums. Our claims practices reflect this agreement. If The Standard has not determined participant coverage eligibility after 90 days, your employees and their beneficiaries will generally be covered if EOI is the only basis for denial.

The Standard will not reconsider claims that were decided prior to April 23, 2023. However, for gross EOI misadministration, The Standard may reconsider coverage in accordance with the terms set out in its policies or the Prudential settlement.1

This means you as the policyholder have a responsibility to confirm that The Standard has approved the employee’s or the eligible dependent’s EOI prior to collecting premiums for voluntary coverage that requires EOI.

You may be liable to the employee’s beneficiaries or eligible dependents in the event you collect premiums from employee for supplemental coverage that requires EOI without first confirming that Standard has approved such EOI.

Make sure your employees understand our EOI practices.

You can learn more about this settlement and its nuances by reading the news release.

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