GROUP INSURANCE GUIDELINES
Regarding Activated Reservists, War, Acts Of War, And Terrorism
General information on reservists called to active duty
Since our group contracts are often customized to meet a particular customer's needs, it is important to check the specific group's contract language regarding continuation and reinstatement rights available under the policy.
Continuation: Lincoln Financial Group will permit group policyholders to continue their activated reservists' Life, AD&D and Disability coverage for the longest continuation period available to other non-disabled employees during approved leaves of absence, under their specific group contracts. This will typically be three insurance months, but may be longer or shorter under some contracts. Premium, including any contributory portions, must be paid through the employer during the continuation period.
Under Dental contracts, for military leaves beginning prior to December 10, 2004, coverage may be continued for insured employees and their dependents for up to 18 months of active duty. For military leaves beginning on or after December 10, 2004, Dental coverage for insured employees and their dependents may be continued for up to 24 months of active duty. Premium must be paid through the employer during the continuation period, at the COBRA continuation rate.
At the end of the applicable continuation period, group coverage will end. At that time, employees and their dependents may use any conversion or portability options contained in the specific group contract, subject to the terms of the policy.
Reinstatement: When a reservist returns to work with the same group policyholder within 90 days of an honorable discharge from active duty, coverage can be reinstated-if the policy remains in force and the reservist is re-enrolled within 31 days of resuming active work. The returning employee will be credited with time served (prior to commencement of the leave) against any eligibility waiting period or pre-existing condition limitation in the contract, including any benefit waiting period in a Dental policy. However, unless otherwise provided by state law, a new pre-existing condition period must be satisfied for any condition initially occurring after the end of his or her coverage continuation period and prior to his or her reinstatement date.
General Information on War, Acts of War, and Terrorism
Even though coverage may be continued as outlined above, it is important to note that a number of Lincoln Financial products include an exclusion for war-related claims. The most commonly-used provision states: "Benefits are not payable for any loss to which a contributing cause is war or any act of war, declared or undeclared."
War and Military Service Exclusions: Our group life insurance contracts do not contain exclusions for losses due to war or acts of war, or for losses sustained during military service. There are exclusions for losses due to war, or acts of war, and for losses sustained during military service in the Company's standard group AD&D, LTD, newer STD and Dental, and Exec-U-CarE® medical reimbursement policies.
In general, 'war' is interpreted to involve hostilities between two or more governments or sovereign nations. Due to the nature of terrorism, it is not possible to determine with certainty events that will be considered 'war' or 'acts of war' in the future. For example, an act of violence (a terrorist event) by individuals or political groups who are not employed by, or acting on behalf of, a sovereign nation or currently ruling government, would not likely fall into the war exclusion. However, the war exclusion could apply to a violent act if the terrorist group is allied with, or acting in concert with, a nation or government in attacking citizens of the United States, especially in times of overseas hostilities.
Lincoln Financial is committed to reviewing claims on an individual case-by-case basis based on our contractual wording and circumstances surrounding the claim. Our analysis of individual claims during a war situation would include review of the actual policy language, circumstances under which the loss occurred, any hostilities surrounding the associated claim, and whether hostilities caused the claim. Note that procedures may vary to comply with state or federal laws applicable during the time of loss.