| DOB: | Date of birth of disabled person |
| Disability Date: | Date claimant's disability |
| Claim Type: | D - Death and ND - Non-Death claims such as Accidental Dismemberment, AB - Accelerated Benefit |
| Product: | BL - Basic Life, BA - Basic AD&D, AL - Additional Life, AA - Additional AD&D, DL - Dependent Life, SL - Supplemental Life, PL - Paid Up Life, VL - Voluntary Life, VA - Voluntary AD&D |
| Product Status: | Approved - product has been approved, Pending - still in review, Denied - product was denied |
| Amount: | Amount of claim in review or approved |
| Date of Approval: | Date waiver of premium is approved (left blank if net yet approved) |
| Claim Status: | Overall status of claim A - Active, C - Closed, P - Pending |
| Claimant Name | Claim Nbr / Recv Date Last 4 SSN / DOB |
Disability Date | Claim Type | Product / Status | Amount | Date Approved Claim Status |
|
|---|---|---|---|---|---|---|---|
| LINDA AMES | B01111 8857 |
mm/dd/yyyy mm/dd/yyyy |
mm/dd/yyyy | ND | BL Approved |
2,000.00 | mm/dd/yyyy Active |
| TOM BANKS | B02222 8787 |
mm/dd/yyyy mm/dd/yyyy |
mm/dd/yyyy | ND | BL Approved AL Pending |
10,000.00 20,000.00 |
mm/dd/yyyy Pending Pending |
| PAULA DAVIDSON | B03333 8878 |
mm/dd/yyyy mm/dd/yyyy |
mm/dd/yyyy | ND | AL Approved BL Approved |
10,000.00 20,000.00 |
mm/dd/yyyy Active Active |
| JIM SMITH | B04444 4444 |
mm/dd/yyyy mm/dd/yyyy |
mm/dd/yyyy | ND | AL Approved BL Approved |
20,000.00 10,000.00 |
mm/dd/yyyy Pending Pending |