In the urgent situation of a terminal diagnosis, it is not uncommon for the insured to be unable to complete the claim procedures themselves. To ensure the family can smoothly receive the Living Benefit Payment from the Living Needs Rider, understanding the “Designated Agent Claim System” is essential. This article explains the conditions under which a family member can file a claim as an agent and the necessary preliminary procedure of designating an “Agent for Claim.” Furthermore, we will cover the general timeline for this highly urgent benefit, which is often paid out in as little as 5 business days after document submission. Please confirm the preparations needed to maximize the utility of this rider.
1. Principle: Claim by the Insured Themselves
Since the Living Benefit Payment from the Living Needs Rider is intended for the insured’s treatment and living expenses, the principle is that the insured themselves must file the claim.
2. Exception: Claim by the Designated Agent for Claim
Only under “special circumstances” detailed below, a person designated in advance at the time of contract as the “Designated Agent for Claim” can file the claim as the insured’s representative.
| Examples of Special Circumstances | Purpose |
| Insured is in a state of mental incompetence or difficulty in expressing intent. | The person is unable to file a claim due to being bedridden, having a consciousness disorder, or severe dementia. |
| The insured has not been informed of the 6-month life expectancy. | The doctor or family has decided not to inform the insured of the terminal diagnosis. |
3. Who Can Be a Designated Agent for Claim?
The scope of individuals who can be a Designated Agent for Claim varies by insurance company, but generally includes those who fall under one of the following categories:
- The insured’s legal spouse.
- The insured’s lineal relatives (children, grandchildren, parents, etc.).
- Relatives within the third degree of kinship who live with or share a livelihood with the insured.
【Important】 For a family member to file a claim as an agent, the “Designated Agent Rider” must be attached to the life insurance contract, and the “Designated Agent for Claim” must be specified in advance. This rider is generally free of charge.
Time Until Payment
The Living Benefit Payment for the Living Needs Rider is generally paid out relatively quickly after the necessary claim documents arrive at the insurance company.
1. General Timeline and Period Until Payment
| Step | Content | Estimated Duration |
| ① Contact & Obtaining Documents | Contact the insurance company and express the intent to file a claim. | Immediate to a few days |
| ② Preparation of Doctor’s Certificate | Ask a doctor to prepare a certificate stating the diagnosis of a “life expectancy of 6 months or less.” | A few days to 1 week |
| ③ Submission of Claim Documents | Send necessary documents (doctor’s certificate, claim form, ID, etc.) to the insurance company. | – |
| ④ Insurance Company Review & Payment | The insurance company confirms and reviews the documents and transfers the benefit to the designated account. | Usually about 5 business days after document arrival |
2. Reason for the Short Payment Period
The Living Needs Rider is designed considering the urgent need for funds by the insured and their family following a terminal diagnosis. Therefore, insurance companies maintain a system to expedite the review and payment procedures compared to typical insurance claims and benefits.
However, if there are deficiencies in the documents or if confirmation of the doctor’s diagnosis is required, the payment may take longer.
It is extremely important to check if your life insurance policy includes the “Designated Agent Rider” and who you have specified as the Designated Agent for Claim to ensure your family can use the rider with peace of mind.
