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Frequently Asked Questions for Disability Claims

As you and your employees have questions about disability claims, we provide resources to answer those questions promptly.

Common questions & answers:

When and how to file a claim?

What should be expected after filing a claim?

What is needed if I also have Long-Term Disability Insurance?

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How are benefits calculated?

What happens after a claim is approved?

Do you offer any Return to Work Services or Social Security Disability Assistance?

Other Information

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From what location will your organization process claims?

Life and Disability claims are administered primarily in Principal Life Insurance Company's home office in Des Moines, Iowa. Some STD claims are handled at our office in Indianapolis, Indiana. The claim area is staffed 7 a.m. to 5 p.m. Central time. The Life & Disability Claim department has both a toll-free phone number, 800.245.1522, and a toll-free fax number, 800.255.6609. All of our staff have voice mail, which allows voice mail messages to be left 24 hours a day, 7 days a week. Additionally, our 800-fax number is available 24 hours a day/7 days a week.

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When should a Short-Term Disability (STD) or Long-Term Disability (LTD) claim be filed?

For STD, a claim should be filed as soon as the employee is aware that he/she will be off work beyond the elimination period. For LTD, we typically advise that the claim is filed no later than half way through the LTD elimination period.

There are many advantages to filing a claim early. Early notification helps us be proactive in obtaining additional information that may be needed to make the initial claim decision. It also assists us in making timely decisions. Once the claim is filed, a claim manager is assigned to the claim. The claim manager will be your point of contact for any claim questions that may arise.

There are 4 sections to the claim form: the HIPAA Authorization, the Employer Section, the Employee section and the Physician section. All 4 sections must be completed. Note: If you have both STD and LTD coverages with Principal Life, and you have already filed an STD claim, you do not need to file a separate form for the LTD coverage.

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How are claims submitted?

A Disability claim can be filed the following ways:

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Once I have submitted the claim, will additional information be needed?

Having the claim form completed in its entirety will assist us in our claim evaluation, as well as, reduce our need to contact you for additional information. If the insured completes the online claim form or telephonic claim form is completed by the employee, we will contact the employer to obtain additional information.

If your plan is based on W-2 earnings, and an employee has been employed for more than one calendar year, we ask that the employer provide a copy of the prior year(s) W-2. For those employed less than one calendar year, we will need all earnings for completed months. If the claim is filed for an owner, please make sure to specify this on the form and we will contact you regarding what is needed for this situation.

To determine eligibility, we also request job descriptions. We need to know the physical demands of the occupation so that we can compare them to the restrictions and limitations provided by their physician.

For customers who have contributory coverage and are self-accounting groups we request a copy of their enrollment form. This form assists us in verifying that an employee enrolled timely for coverage. It also shows us what coverage the insured elected.

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What is the timing goal for Short-Term Disability claim determinations?

Our goal for adjudicating STD claims is seven days from the receipt of the claim. In circumstances where additional information is needed to make a decision, we will pend the claim until we receive the additional information.

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How often are STD benefit checks issued?

We issue STD benefits on a weekly basis. For routine maternities and some routine surgeries, we offer a lump sum payout for the approved duration period.

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Why do you sometimes need additional information before making a decision on a claim?

To be eligible for benefits, the employee must meet the definition of disability according to the insurance contract. Objective documentation such as physician's office notes, treatment records, hospital records or a physician statement may be required. If we are waiting for information from an outside source, the decision time will depend on when the information is received.

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Are benefits guaranteed once a disability claim is filed?

No. The employee must meet the definition of disability as defined by the contract. The medical information submitted must support the definition of disability and cannot be based simply on a physician's opinion. Each claim is reviewed to determine if it meets the contractual requirements for benefit payment.

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What is the timing goal for Long-Term Disability claim determinations?

The claimant will be contacted with an acknowledgement letter within five business days of receipt of the LTD claim. A follow-up phone call will be made to conduct a phone interview to gather additional information. Our goal is to make the LTD decision the later of 45 days from the receipt of the claim or by the completion of the elimination period.

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If we have both STD and LTD coverage, will we need to file a second claim form for the LTD?

A new claim form is not required when moving from STD to LTD when you have an integrated disability program. Our goal is to provide integrated claim processing to streamline claim administration. Some of the features of our integrated process include: single notification of claim, one claim form, smooth and timely transition from STD to LTD whenever possible, early intervention and case management.

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What options do employees have for receiving their LTD benefits?

Principal Life offers two monthly LTD payments options:

  • Regular check – We will mail a check to the employee's address allowing sufficient time to reach the employee by the benefit due date. LTD payments are made the 10th of the month.
  • Electronic Funds Transfer (EFT) – Employees can elect EFT, which allows us to transfer the employee's LTD benefit to a bank account designated by the employee. We will transfer funds allowing sufficient time to reach the employee's account by the benefit due date.

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How do you figure the employee's disability benefit?

The contract dictates the percent of benefit or defines a flat benefit the employee is entitled to. The benefit is calculated by multiplying the employee's pre-disability income by the benefit percent minus any other income sources. The contract may also contain a maximum and minimum benefit payable.

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What is integration with other income sources?

Our contract supports the integration of other income sources you are eligible for. This means the benefit is reduced by the amount of income received from other income sources, such as (see the contract for full details):

  • Social Security, Employee and Family
  • Worker's Compensation
  • State Disability Benefits
  • Salary Continuance

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If returning to work on a part-time basis, how are part-time earnings provided?

We must receive part time earnings on a weekly basis for STD and monthly basis for LTD. We will need the number of hours worked each week/month and the rate of pay. Your employer can use our form to submit this information to us via our 800-fax (800.255.6609). We can calculate the partial benefit once we receive this information.

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What are Benefit Duration Guidelines?

Principal Life uses several common industry resources to evaluate the length of disability, as well as our in-house nurses, physicians and outside consultants. We consider each claim to be unique and evaluate every claim individually. Additional factors are taken into consideration when applying duration guidelines, including the employee's age, occupation and possible secondary diagnosis.

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How are phone calls handled?

We have a trained, dedicated Call Center to assist with general questions. More specific questions are transferred directly to the claim analyst. This ensures that the person talking to you will have the most knowledge concerning the claim.

Our callers also have the ability to direct dial to the specific claim analyst that has been assigned to their claim. Our phone system allows calls that have not been assigned to be distributed randomly by "hunt groups" to allow for continuous coverage and back-up by trained staff.

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Who screens claims for case management?

We triage our claims and develop an action plan on all claims, except for normal pregnancy and claims where the employee returns to work within the expected duration guidelines. The claim analyst, nurse consultant, and vocational consultant participate in this process. We believe this team approach allows us to identify the appropriate case management resources for every claim as early as possible.

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Do you have a formal rehabilitation program?

We have qualified rehabilitation professionals on staff to provide rehabilitation services to our claimants. We prefer to use our in-house professionals, rather than outside vendors, as it gives us greater control over the quality of services and better outcomes on cases. We utilize vendors when there are geographical issues best handled by someone locally.

Our primary goal is to help the employee go back to work at their regular occupation for their employer. If this will not be possible, we will work with the employee to find alternate placement through a full spectrum of vocational and outplacement services.

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Do you help disabled employees apply for Social Security Disability benefits?

The Principal Life Insurance Company understands that people who are seriously disabled benefit from being awarded Social Security Disability benefits (SSDI) as quickly as possible. Our staff of highly skilled and respected Social Security Consultants consider the educational, medical, and vocational history of each claimant, and evaluate the appropriateness of pursuing SSDI benefits for our claimants receiving group and individual disability benefits. Our Consultants then work with our network of preferred providers of Social Security advocacy and representation services to provide these services directly to our disability claimants. We are able to support our claimants through this process by answering questions, navigating and explaining the often complex rules of the SSDI process, assisting claimants with submitting paperwork and forms at the right time, gathering medical information that supports their claim for SSDI benefits, and representing claimants throughout the SSDI process. Our claimant-focused approach is a key factor in both our high success rate of SSDI approvals, and also the large percent of approvals we obtain prior to the Administrative Law Judge level.

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What information is needed when returning to work?

We ask that we are notified as soon as possible once the employee returns to work to avoid overpayment. You may reach us at 800.245.1522. We will need the employee's name, the date he/she returned to work, and whether the employee returned to full or part time work.

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If working ceases for disability or any other reason, do I need to notify Principal Life Insurance Company?

When an employee ceases to work for any reason, it is important for the employer to review the Continuation section of the applicable STD, LTD or Life products you have with us. This will assist you in determining how long premiums are allowed to be continued for the employee's benefits. With regards to Life Coverage, the employer should determine if they are responsible for offering the employee the right to convert their policy to an individual plan when appropriate.

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Do you have any web-based claim reports, and if so, how would I access them?

As an Employee, you can access disability claim reports 24/7 at www.principal.com. Here's how to access them:

  • Login
  • Choose Personal
  • Enter User Name and Password
  • Contact us at 1.800.621.6280 to request a password.
  • From this site, you can review any coverage you have with the companies of the Principal Financial Group.

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IN17640
04/2006

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