If you have an optional supplemental UBA Gap Product that includes Group Accident Insurance underwritten by United States Fire Insurance Company and you have a Claim, the claims administrator (CBP) will get all the necessary documentation and make sure that all other insurance paid already has been accounted for and then when they determine the amount you qualify for a claim, you will be paid one of the two ways below:
- If you paid the provider directly and showed proof of payment to the claims administrator when you filed the claim, the claims administrator will send the claim payment to you for reimbursement.
- If you did not pay the provider and just submitted the claim to the claims administrator, the claims administrator will send the claim payment directly to the providers in question if there is an assignment of benefits.
Eligibility will be determined by the plans, limitations, terms & exclusions.
Note: If you paid the provider directly and didn't show that you paid them directly to the claims administrator, the claims administrator will not know that you paid the provider directly so they will still pay the provider instead of you so it is important if you did pay the provider to include proof of that payment at time you submit the claim.
Don't forget that the Group Accident Medical Expense Insurance is secondary, meaning that all other insurance pays first and then what you are truly out-of-pocket for the covered expense is what you are eligible for up to the annual maximum benefit (minus the Deductible). Make sure to read your Member Guide and Certificates of Insurance for your product carefully to know how the Group Accident Insurance works: what is covered or what is in the limitations or exclusions.
Any questions regarding Group Accident Insurance, you can contact us at 866.438.4274 and we will be happy to help you.
Note: If you are looking for Group Accident Only Insurance underwritten by Guaranteed Trust Life Insurance Company ("GTL"), their products work based on a schedule of benefits for different services and procedures related to the accident. Make sure that you view the Certificates of Insurance for your product as well as your Member Guide to know how your product works and will pay. You can view your Certificates of Insurance by logging in to your Member Portal by selecting the link below:
Important: Healthy America and United Business Association (UBA) are not authorized to pay claims or be involved in the claims decision process. All claim decisions are made by the TPA claims administrator and the insurance carrier.