FAQs

Insured Customer 

  • Will APL extend grace periods for premium payments due to the COVID-19 crisis?
    Yes, as we move through this crisis, we’re working with the Department of Insurance in each state to insure we're in compliance in regard to extended grace periods and any other requested policy change. We’re going to make reasonable accommodations for our insureds based on individual needs. Our team will work with each individual group to determine an appropriate payment plan based on their situation.
  • How will claims be paid during the extended grace period?
    Claims received while we’ve received premiums will be processed as usual. We will properly adjudicate all valid claims under active policies.
  • Is APL staffed to handle normal business operations, including the processing of claims?
    Yes, we have almost 90% of our colleagues working remotely and business is being processed as usual. We are keeping our normal business hours.

 

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FAQs

Product Coverage 

  • Do APL products cover COVID-19 (coronavirus)-related claims?
    Some of our products cover coronavirus-related claims, and we will follow the provisions shown in our policies to determine coverage as would be provided for any other sickness. We will also comply with any legislation set forth by the government at the state and/or federal level. See below for a brief description of whether particular product lines provide coverage for coronavirus-related claims, assuming all other policy provisions have been met.
     
  • MEDlink® Series (Gap Insurance)
    Hospital admission/confinement due to coronavirus will be considered for eligible benefits provided all other provisions of the policy are met. This includes, but is not limited to, meeting the inpatient hospital definition for the facility to which the insured is admitted/confined.
     
    If the Outpatient Benefit is included in your certificate and you are treated on an outpatient basis at the hospital or in the hospital’s emergency room for coronavirus, benefits will be considered under the Outpatient Benefit provided all other provisions of the policy are met. This includes, but is not limited to, meeting the outpatient facility definition for the facility where the insured is treated.
     
    If your certificate includes the Physician Outpatient Treatment Rider or the Office Visit Fee Rider, the office visit fee will be considered for treatment of coronavirus provided all other provisions of the policy are met. This includes, but is not limited to, meeting the facility definition where the insured receives treatment. Telemedicine is treated as an office visit under this benefit.

    If your certificate includes the Independent Lab Facility Rider, benefits will be considered for diagnostic testing in a covered facility as defined in your certificate provided all other provisions of the policy are met.
     
  • Hospital Indemnity Insurance
    Hospital admission/confinement due coronavirus will be considered for eligible benefits provided all other provisions of the policy are met. This includes, but is not limited to, meeting the inpatient hospital definition for the facility to which the insured is admitted/confined.
     
    If your certificate includes the Outpatient Sickness Treatment Rider or the Outpatient Accident and Sickness Treatment Rider, the emergency room charges or the office visit charges for treatment of coronavirus will be considered provided all other provisions of the policy are met. This includes, but is not limited to, meeting the facility definition where the insured receives treatment. Telemedicine is treated as an office visit under this benefit.
     
    If your certificate includes the Diagnostic Testing Benefit, a presently covered test that will diagnose coronavirus will be considered provided all other provisions of the policy are met. This includes, but is not limited to, meeting the facility definition where the insured receives treatment.
     
  • Short Term Disability Income Insurance
    Short Term Disability insurance may cover you after the elimination period if you are disabled according to the policy definition. Please remember that the policy only pays for benefits from the end of the elimination period until recovery, or the policy maximum, whichever is less. Insureds who are quarantined without being totally disabled according to the policy definition would not be eligible for a benefit under Short Term Disability insurance. Additionally, as we move forward with disability claim reviews during this epidemic, we may find that the last day worked and the last day an insured claimant is compensated by his or her employer do not coincide. On any claims where disability begins after 3/1/2020, we will verify the last day an employee received, or will be receiving, compensation from their employer when appropriate.
     
    Insured workers who are self-quarantined are not considered to be disabled unless they have a medical condition that results in restrictions and limitations that satisfy the policy’s definition of disability. This includes the requirement that the insureds be under the regular care of a licensed physician or doctor as a result of the medical condition. If the employer mandates a quarantine period for an employee, disability benefits will not be considered unless the employee is diagnosed with a medical condition eligible for benefits under the plan.
     
    Quarantined insureds are considered “actively at work” if the quarantine is the result of a governmental or medical order. If an insured person self-quarantines, and is unable to work, they are llikely not “actively at work.” However, coverage may continue if they are taking paid time off and premiums are paid.
     
  • Accident Insurance
    COVID-19 (coronavirus) does not meet the definition of an accident under the terms of APL’s accident policies and would not be covered.
     
  • Cancer Insurance
    COVID-19 (coronavirus) does not meet the definition of cancer under the terms of APL’s cancer policies and would not be covered.
     
  • Intensive Care Policies and Intensive Care Riders
    Benefits for admission to the Hospital Intensive Care Unit as defined by the policy or rider due to COVID-10 (coronavirus) or its complications would be considered.
     
  • Critical Illness Policies and Critical Illness Riders

    COVID-19 (coronavirus) does not meet the definition of critical illness under the terms of APL’s critical illness policies or riders and would not be covered.

 

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