IQVIA Benefits Handbook
HOW BENEFITS ARE PAID
To claim an AD&D benefit, you or your beneficiary must notify the IQVIA Benefits Marketplace at 888-264-9180 of the covered individual's injury or death. IQVIA will confirm the beneficiary designation and assist in the completion and submittal of paperwork to Lincoln.
Once submitted, Lincoln will review the claim and any supporting documentation. If additional information is needed, the beneficiary of record will be contacted directly.
Lincoln will pay benefits immediately once an AD&D claim is approved. You or your beneficiary will be notified of Lincoln's decision as soon as it is made.
AD&D benefits are paid based on your (or your dependent's) coverage amount, depending on the type of loss, as shown below:
If, due to a covered accident, you lose…
You receive this percentage of your AD&D coverage amount…
Your life
100%
Both hands, both feet or entire sight in both eyes
100%
Speech and hearing in both ears
100%
One hand and one foot
100%
One hand or foot and sight of one eye
100%
One hand or one foot
50%
Speech or hearing in both ears
50%
Quadriplegia, paraplegia, hemiplegia, diplegia
50%
Monoplegia
25%
Sight in one eye
50%
The thumb and index finger of one hand
25%
The most Lincoln will pay for any combination of covered losses from any one accident is 100% of your covered amount.
If you or your eligible dependent become paralyzed within 365 days of a covered accident, the AD&D Plan will pay benefits as follows:
  • Monoplegia: 25 percent of the coverage amount. Monoplegia is the total and irreversible paralysis of one arm or one leg.
  • Hemiplegia: 50 percent of the coverage amount. Hemiplegia is the total and irreversible paralysis of upper and lower limbs on one side of the body.
  • Paraplegia: 50 percent of the coverage amount. Paraplegia is the total and irreversible paralysis of both lower limbs.
  • Quadriplegia: 100 percent of the coverage amount. Quadriplegia is the total and irreversible paralysis of both upper and lower limbs.
To be eligible for AD&D benefits, you must be covered by the plan, the loss must result from accidental bodily injury and the loss must occur within 365 days of a covered accident. In the event of death, benefits are paid to a beneficiary; otherwise, benefits are paid to you or your eligible dependent.
Defining AD&D Terms
For purposes of the AD&D Plan, loss means:
  • For an eye: An entire and permanent loss of sight that is irrecoverable by natural, surgical or artificial means.
  • For a hand or a foot: The limb is severed at or above the wrist or ankle.
  • For speech or hearing: An entire and permanent loss of either speech or hearing that is irrecoverable by natural, surgical or artificial means.
  • For thumb and index finger: The finger and thumb on the same hand are severed at or above the joint closest to the wrist.
Paralysis and severance is defined as follows under the AD&D Plan:
  • Paralysis: Total loss of use of a limb. A physician must determine the loss of use to be complete and irrecoverable.
  • Severance: Complete and permanent separation and dismemberment of the part of the body.