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Claims In the event that you need to file a claim for insurance benefits, we will gladly assist you throughout the entire claims process.
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Claims
Introduction Picture
Introduction Picture
In the event that you need to file a claim for insurance benefits, we will gladly assist you throughout the entire claims process.

How to file a claim

Simply download and complete the appropriate claim form (or contact us at 866-257-0707) which can be found in the Forms Center within your online account, and then send it to us along with the required supporting documentation, as listed on the form. For your protection, we ask that all claims be made in writing. Depending on the type of benefit requested, supporting documentation may include any of the following:

  • Physician's report
  • Death certificate
  • Monthly P&L statements
  • Medical records
  • Federal income tax return

Who should file the claim?

Term Life, Level Term Life or Term Plus® Universal Life claims

Claims for an ADA member who is deceased should be filed by the member's named beneficiary. If you are unsure of who has been named beneficiary, please contact ADA Members Insurance Center at 800-568-2001.

Most life insurance claims are processed very quickly, pending receipt of all necessary documentation. We make every attempt to issue benefit checks to beneficiaries within 10 business days after we receive all required information. Please allow a few extra days for your check to reach you via standard U.S. mail.

Term Life Disability Waiver of Premium and Term Plus Universal Life Disability Waiver of Premium claims should be filed by the ADA Member (primary certificate holder).

Disability Income Protection and Office Overhead Expense claims

The ADA Member (primary certificate holder) should file any claim under the Disability Income Protection or Office Overhead Expense Disability Plan as soon as possible after the start of your disability. The review process for disability claims can take up to several weeks or longer, depending primarily on the timely receipt of critical information from you and your physicians. Before benefits can be released, reports from your physicians and clinical records, along with any required financial records for you and/or your practice, must be reviewed and you must have satisfied your waiting period.

Your assistance in obtaining clinical information from your physicians and in providing necessary financial documentation can make a big difference in expediting the review process.

MedCASHSM Hospital claims

The ADA Member (primary certificate holder) should file any MedCASH claim, including those pertaining to a covered spouse or dependent child. Most benefits can be released once you have satisfied the required waiting period (if any). Hospital Coverage benefit checks are typically issued within 10 business days after all necessary claim requirements have been met. Please note that your health insurer's EOB (explanation of benefits) statement does not provide us with all the information we need to process your claim.

MedCASHSM Critical Condition claims

Critical Condition benefit checks are issued as soon as the appropriate survival period and waiting period have been satisfied, following the receipt of all necessary documentation. Receipt of your medical records is required for Critical Condition benefits; in particular, your physician will need to provide a confirming clinical diagnosis of qualifying condition before benefits can be paid. In some cases we may need to request additional information

Payment of benefits for all Plans is subject to approval based on the qualifications outlined in your certificate(s). For additional information about claims procedures or policies, contact us at 866-257-0707 or adaclaims@protective.com.

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The information on this website is not a contract. Protective refers to Protective Life Insurance Company (PLICO) and its affiliates, including Protective Life and Annuity Company (PLAIC). PLICO, founded in 1907, is located in Nashville, TN and is licensed in all states excluding New York. PLAIC is located in Birmingham, AL, and is licensed in New York.

Protective® is a registered trademark of PLICO. The Protective trademarks, logos and service marks are property of PLICO and are protected by copyright, trademark, and/or other proprietary rights and laws. ADA® is a registered trademark of the American Dental Association (ADA). ADA Members Insurance Plans® is a registered service mark of the ADA. The ADA trademarks, logos, and service marks are the property of the ADA and used by Protective with permission. In some states, the ADA is entitled to receive royalties from the ADA Members Insurance Plans.

ADA Members Insurance Plans refers to the group life, disability, and supplemental medical policies issued by PLICO and PLAIC to the ADA.

Policies issued by PLICO in all states except New York: Term Life Insurance1 (TL-P 1-21), Student Term Life Insurance (TL-ST-P 2-21), Universal Life Insurance1 (TP-P 11-20), Level Term Insurance2 (LT-P 1-21), Disability Income Protection Insurance3 (IP-P 7-20), Office Overhead Expense Disability Insurance4 (OE-P 9-20), Student Disability Income Insurance3 (ST-P 8-20), Hospital Indemnity Insurance (HI-P 11-20), and Critical Illness Insurance (CI-P 7-20).

In New York, policies issued by PLAIC: Term Life Insurance1 (TL-P-NY 1-21), Student Term Life Insurance (TL-ST-P-NY 2-21), Universal Life Insurance1 (TP-P-NY 2-21), Level Term Life Insurance2 (LT-P-NY 2-21), Disability Income Protection Insurance3 (IP-P-NY 12-20), Office Overhead Expense Disability Insurance4 (OE-P-NY 01-21), Student Disability Income Insurance1 (ST-P-NY 1-21), Hospital Indemnity Insurance (HI-P-NY 1-21), and Critical Illness Insurance (CI-P-NY).

Consult the policy for benefits, riders, limitations, and exclusions. Benefits adjusted for misstatements of age or sex. Benefits are provided under a group policy issued to the ADA. Each Plan participant will receive a Certificate of Insurance explaining the terms and conditions of the policy. An insured must maintain continuous ADA membership to remain eligible for insurance.

1For term life insurance and universal life insurance, premiums increase annually based on age. The Premium Credit is not guaranteed but reevaluated periodically. Universal life recommended premiums consist of the costs of insurance (which vary based on the member’s age and coverage amount), the amount a member places into the Policy Value Account and service charge. Premium deposits may fluctuate or remain level.

2For level term life insurance, premiums are fixed based on the member’s age, gender and coverage amount at issue.

3Premiums increase every five years based on age for disability income protection. Premium Credit is not guaranteed but reevaluated periodically.

4Premiums increase every 10 years based on age to age 60 and every 5 years thereafter to age 75 for office overhead expense disability. Premium credit is not guaranteed but reevaluated periodically.

Coverage for dental student members is issued regardless of condition if under age 60. Coverage automatically renews each academic year. Individuals may convert coverage to the plans for practicing dentists after graduation by paying member premiums and maintaining continuous ADA membership.

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