A claim must be filed in writing to the CGLIC Claims Office for Family Adjustment Insurance and Family Income Insurance, or MetLife for Contributory Group Life Insurance, or Benefits Administration for any uninsured benefit. CGLIC, MetLife or Benefits Administration, as appropriate, is responsible for determining entitlement to a benefit and any amount payable under the Plan.
For Family Adjustment Insurance and Family Income, write to:
CGLIC Claims Office
P.O. Box 22328
Pittsburgh, PA 15222-0328
Written proof of loss must be given to CGLIC within 90 days after the date of the loss for which claim is made. If written proof of loss is not given in that time, the claim will not be invalidated nor reduced if it is shown that written proof of loss was given as soon as was reasonably possible.
For Contributory Group Life Insurance, write to:
Utica Life Claims
P.O. Box 3016
Utica, NY 13504
For Contributory Group Life Insurance, written proof of a claim must be given to MetLife not later than 90 days after the date of the loss. If notice or proof is not given on time, the delay will not cause a claim to be denied or reduced as long as the notice or proof is given as soon as possible.
For any uninsured benefit claim, write to:
ExxonMobil Life Insurance Program
P. O. Box 2283
Houston, TX 77252-2283
All uninsured death benefit claims should be filed within ten years of the date of death. The appropriate claims administrator will review your claim and respond to you within a reasonable period of time, normally within 90 days after receiving your claim.
If your claim is denied completely or partially, you or your beneficiary will receive written notice of the decision. The notice will describe:
- The specific reasons for the denial;
- Any additional information or material that is needed to validate the claim and the reason that information is required; and
- The process for requesting an appeal.
If the claims administrator needs additional time to decide on your claim because of special circumstances, you will be notified within the 90-day period. You will receive a response no later than 180 days after your claim was received initially.
Filing a mandatory appeal
If your claim is denied, you, your beneficiary or your designated representative may file an appeal no later than 60 days from the date of the denial. File the appeal with CGLIC for Family Adjustment Insurance and Family Income Insurance, with MetLife for Contributory Group Life Insurance, and with the Administrator-Benefits for any uninsured benefit claim denial.
The written appeal should include the reasons why you believe the benefit should be paid and information that supports, or is relevant to, your claim (written comments, documents, records, etc). The written appeal may also include a request for reasonable access to, and copies of, all documents, records and other information relevant to your claim. The review will take into account all comments, documents, records and other information submitted relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination. You will receive a response to the appeal within 60 days from the date the appeal was received.
If additional time to decide on your appeal is needed because of special circumstances, you will be notified within the 60-day appeal response period. If the appeal is denied, you will receive written notice of the decision. The notice will set forth:
- The specific reason(s) for the denial and the Plan provisions upon 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 the claim.
- A statement of the voluntary appeal procedure and your right to obtain information about such procedure or a description of the voluntary appeal procedure.
- A statement of your right to bring an action under section 502(a) of the Employee Retirement Income Security Act (ERISA).
Statute of limitations
After you have received the response of the mandatory appeal, you may bring an action under section 502(a) of ERISA. Such action must be filed within one year from the date your mandatory appeal was denied.
Filing a voluntary appeal for an uninsured benefit only
If an appeal for an uninsured benefit is denied, an appeal to the Administrator-Benefits may be available. New information pertinent to the claim is required for the voluntary appeal to be considered. You must submit your voluntary appeal within 30 days of the denial of your mandatory appeal. The statute of limitations or other defense based on timeliness is suspended during the time that a voluntary appeal is pending.
You will be notified within 15 days after your request was received that such information was considered or is not pertinent. If it is determined that there is new relevant information, a decision will be made within 60 days after the Administrator-Benefits receives your request for a voluntary appeal. If it is determined that there is no new information pertinent to your claim, your voluntary appeal will not be considered.
No implied promises
Nothing in this SPD says or implies that participation in the ExxonMobil Life Insurance Program is a guarantee of continued employment with the company.
Future of the Plan
ExxonMobil has the right to change, suspend, withdraw, amend, modify or terminate the Program or any of its provisions at any time and for any reason. A change may also be made to required contributions and eligibility for coverage, and may apply to those who retired in the past, as well as those who retire in the future. If any material changes are made in the future, you will be notified.