Filing Short-Term Disability Claims

You may report a claim up to 30 days in advance of a planned disability absence OR as soon as you are aware that you will be disabled due to illness or injury for seven or more calendar days. You can report your claim online or by phone. You must also complete an Authorization to Release Information form and leave it with your attending physician.

Filing Long-Term Disability Claims

You and DallasNews Corporation must complete forms provided by the claims administrator, then have your attending physician complete the appropriate section of the form and send it directly to the claims administrator. Your claims administrator depends on your date of disability. To file a claim, click on this link.

Proof of Disability

The claims administrator requires you to provide proof of your claim, which may include:
That you are under the regular care of a physician
The appropriate documentation of your monthly earnings
The date your disability began
The cause of your disability
The extent of your disability, including restrictions and limitations preventing you from performing your regular occupation
The name and address of any hospital or institution where you received treatment, including all attending physicians
You should file the claim and provide proof of your disabling condition within 30 days of the date on which your disablijng condition began or became disabling, whichever is later. The date on which your disabling condition began or became disabling is the date your elimination period starts. If your disabling condition continues beyond the date on which the group long term disability insurance policy states your elimination period ends, then your disability benefits can commence, provided you have filed a claim with the long term disability insurer for your claimed disability. However, you must send the claims administrator written proof of your claim no later than 30 days after your elimination period. If it is not possible to provide proof within 30 days, it must be given no later than one year after the time proof is otherwise required (unless you are legally incompetent).
You must notify the claims administrator immediately when you return to work in any capacity. The claims administrator will periodically ask you to ask your doctors to provide updated medical records on your condition and treatment plan and progress. You must provide the requested information to the claims administrator to avoid termination of your benefits or delay in payment of any benefits.
You may, at the claims administrator’s request, be required to provide proof of your continued disability to continue receiving LTD benefits. The claims administrator will pay for an examination by a physician of its choice and may ask its representative to interview you.

Filing Life Insurance and Personal Accident Claims

You (or your beneficiary, if you die) should notify the claims administrator, Lincoln Financial, within 30 days of a death or 12 months of a covered loss. A claim form will be provided to you upon notification. You must complete the claim form and provide proof of the loss (as explained below) within 90 days. If it is not possible to provide proof within 90 days, you must supply it as soon as reasonably possible, but no later than one year after the time it is otherwise required (unless you are legally incompetent).
You (or your beneficiary) must provide a certified copy of the death certificate before death benefits can be paid. Benefits will be paid in a single lump-sum payment as soon as possible after all information is received.

Proof of Loss

The claims administrator (Lincoln Financial) requires you to provide proof of a life insurance or personal accident insurance claim. Proof of your claim includes information about the nature, date and cause of the loss, disability or expense and may require you to submit one or more of the following:
Police accident report
Autopsy reports
Laboratory results
Hospital and physician records
Receipts

Filing Business Travel Accident Insurance Claims

You (or your beneficiary) should notify the claims administrator, The Hartford, within 30 days of the covered loss (or as soon as reasonably possible). The notice should include the insured person’s name and policy number. The claims administrator will send you or your beneficiary a claim form within 15 days after receiving notice of the loss. Complete the claim form and return it with proof of the loss within 90 days.

Eligibility Claims

If there is a question as to whether you or your dependents are eligible for coverage under any benefit option provided by the plans, that question will be decided by the claims administrator. If the eligibility question is not accompanied by a claim for benefits, the decision of the plan administrator will be final and will not be subject to review. However, if the eligibility question is being decided in connection with a claim for benefits, you may appeal the decision of the plan administrator.

Denied Claims

Long-Term Disability

If a claim for LTD benefits is denied, the claims administrator will notify you no later than 45 days after the receipt of the claim. This 45-day period may be extended for an additional 30 days if the claims administrator determines the extension is necessary due to matters beyond the control of the plan and notifies you of the extension before the end of the initial 45-day period. If you have not furnished information that is necessary for determining the claim, the claims administrator will notify you and describe the information that is needed.
If, prior to the end of the first 30-day extension, the claims administrator determines that, due to matters beyond the control of the plan, a decision cannot be made within that extension period, the period for making a determination with respect to the your claim may be extended for an additional 30 days, provided the claims administrator notifies you prior to the end of the first 30-day extension period of the circumstances requiring the extension and the expected date for making a determination.
In addition, in the case of any extension of the period in which to make a determination, the notice of extension will explain the standards on which your entitlement to an LTD benefit is based, the unresolved issues that prevent a determination with respect to the claim and the additional information needed to resolve those issues. You will be given a reasonable period of time, but not less than 45 days, in which to supply the missing information.
While the claims administrator is waiting for the missing information, the deadline for responding to your claim will automatically be extended until 30 days after you furnish the missing information or, if you do not furnish the missing information, until 30 days after the date for furnishing such information.
If an LTD claim is denied by the claims administrator, you will have 180 days to file an appeal of the denial.

Other Claims

With respect to all claims other than claims for medical, dental, vision, flexible spending account and LTD benefits, the claims administrator will notify you of its determination no later than 90 days after the receipt of the claim. This 90-day period may be extended for an additional 90 days if the claims administrator determines the extension is necessary due to special circumstances and notifies you of the extension before the end of the initial 90-day period.
The notice of extension will indicate the special circumstances and the date by which the claims administrator expects to make a determination. If you have not furnished information that is necessary for determining the claim, the claims administrator will notify you no later than 30 days after receiving the claim and will describe the information that is needed. You will be given a reasonable period of time, but not less than 45 days, in which to supply the missing information.
While the claims administrator is waiting for the missing information, the deadline for responding to your claim will automatically be extended until 90 days after the claimant furnishes the missing information or, if you do not furnish the missing information, until 90 days after the date for furnishing such information.
If your claim is denied by the claims administrator, you will have 60 days to file an appeal of the denial.

Notice of Denied Claims

If a claim for benefits is denied, you will be notified in writing, and the written notice will contain the following information:
The specific reasons for the benefit denial
Reference to the plan provisions on which the denial is based
A description of any additional material or information necessary to perfect your claim and an explanation of why such information is necessary
A description of the plan’s appeal process and applicable time limits (including the expedited process applicable to urgent care claims) and a statement of your right to bring a civil action under ERISA following an adverse determination on appeal
If an internal rule, guideline, protocol or other similar criterion was relied on in denying your benefit claim, a statement to that effect (a copy of the applicable rule, guideline, protocol or other similar criterion will be provided to you, upon request, free of charge)
If the benefit denial was based on medical necessity or experimental treatment or a similar exclusion on limit, an explanation of such scientific or clinical judgment and its application to your medical circumstances
If your claim for benefits is denied, you may not bring a lawsuit to recover the denied benefits until you have exercised all of your appeal rights and your appeal has been denied in whole or part.

Appeal of Denied Claims

If you wish to appeal the denial of a claim for benefits under the plan, you or your authorized representative must file written notice of the appeal before the time for filing the appeal expires. Your appeal must be filed with the claims administrator for all appeals related to denied claims for life insurance, personal accident insurance, long-term disability or business travel accident insurance.
Your written notice should state in reasonable detail all of the grounds upon which your appeal is based, including references to applicable plan provisions, and any issues or comments you feel are relevant to your claim. You should supply any documents, records or other information relating to your claim. You may also request copies of documents, records and other information relevant to your claim that are in the possession of the plan, which will be provided to you free of charge.
The appeals administrator will review the denial of your claim without deference to the decision of the claims administrator. If the denial of your claim was based in whole or in part on a medical judgment, the appeals administrator will consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment and who did not participate in the denial of your claim (and is not the subordinate of a health care professional who did participate in the claim denial). The appeals administrator will also identify the medical or vocational experts whose advice was obtained on behalf of the plan in denying your claim, without regard to whether the plan relied on such advice.
The applicable time limits to file an appeal of a benefit denial are set forth below:
LTD Claims: 180 days after the benefit denial; the appeals administrator will issue a decision within 45 days after receiving the appeal (this 45-day period may be extended for up to an additional 45 days on prior written notice to you).
All Other Claims: 60 days after the benefit denial; the appeals administrator will issue a decision within 60 days after receiving the appeal (this 60-day period may be extended for up to an additional 60 days on prior written notice to you).

Notice of Appeal Decision

If your appeal is denied, you will be notified in writing, and the written notice will contain the following information:
The specific reasons for the denial
Reference to the plan provisions on which the denial is based
A statement that you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to your claim for benefits
If an internal rule, guideline, protocol or other similar criterion was relied on in denying your benefit claim, a statement to that effect (a copy of the applicable rule, guideline, protocol or other similar criterion will be provided to you, upon request, free of charge)
If the benefit denial was based on medical necessity or experimental treatment or a similar exclusion on limit, an explanation of such scientific or clinical judgment and its application to your medical circumstances

Other Legal Information

Consistency of Treatment

The plan administrator will take such action from time to time as may be necessary to assure that all claims for benefits under the plan are determined in accordance with the applicable plan documents and that the provisions of the applicable plan documents are applied consistently to similarly situated plan participants and their dependents.

Liability for Payment

Neither DallasNews Corporation nor any DallasNews Corporation company will have any obligation to make a benefit payment to you or your dependents under a plan or program that is fully insured. The insurer is solely responsible to make such benefit payments, and DallasNews Corporation and the DallasNews Corporation companies will have no liability to you or your dependents if the insurer fails to make any payments required under any insured plan or program.
The plans and programs that are fully insured are the following:
Long-Term Disability Plan
Life Insurance Plan (basic, supplemental and dependent life insurance)
Personal Accident Insurance Plan
Business Travel Accident Insurance Plan

Recovery of Overpayments

The amount of your plan benefits will be adjusted if:
You have misstated any information in your application for plan coverage (including any statement of health)
You do not report required information while receiving company provided benefits
Any error is made in calculating your benefits
If a benefit is overpaid or benefits are duplicated, you are expected to repay the plan within 60 days. If you do not, the plan may reduce or refuse future benefits until the overpayment is repaid. The plan may also take additional action allowed by law.
In most cases, no interest will be charged on the amount of any overpayment or duplication of benefits, and, unless required by law, no interest will be paid on any underpayment of benefits or on any benefit payments, which have been delayed for any reason.