Voya Claims 360

The center of the circle says Voya Claims 360, an inner circle says Employer, employee and broker. A circle containing the words Easy, Innovative, Integrated is on the outside.

Helping employees use the Supplemental Health benefits they’re enrolled in

Voya Claims 360 is an integrated and intuitive model designed to simplify the claims process for Supplemental Health Insurance products.

From the time an employee enrolls to when a claim is processed and paid, Voya Claims 360 kicks off a variety of proactive actions to help employees get the most from their benefits.

Support ranges from connecting the dots between coverages and notifying employees when they have a potential benefit opportunity, to even paying benefits for certain covered events automatically. The goal of Voya Claims 360? Simplify and streamline the process for employees.

Simplified claims come full circle

Using this integrated model, Voya Claims 360 includes product-to-product claims integration, intuitive claims payment, medical claims integration and an auto-pay claims process — where we may even pay a benefit automatically. Claims 360 also includes:

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Formless submissions

Employees enrolled in Accident Insurance or Hospital Indemnity Insurance can file a claim online without having to print and sign forms to upload. Also available for Wellness Benefit claims.

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Online claims center

For all of our products, our straightforward claims submission process guides employees through the claims process from the submittal through a claims decision.

Voya Claims 360 is available for these insurance products offered by Voya: 

  • Accident Insurance
  • Critical Illness* Insurance
  • Hospital Indemnity Insurance
  • Short Term Disability Income Coverage

The Voya Claims Center makes the claims process transparent with accessible, real-time monitoring. Once documentation is gathered, many claims can be filed in less than 15 minutes.

Voya Claims 360’s comprehensive support, data-driven messaging and integrated approach include:

Intuitive claims payment model

When an Accident Insurance claim is paid, we also automatically pay for covered follow-up doctor treatments and other related covered medical events or treatments. We also check for active coverage under other Voya-offered products.

Product-to-product claims integration

When a claim is processed, the claims management team cross-references it with the employee’s other available coverages. If another benefit may be available, they’ll reach out to the employee and/or their beneficiaries to let them know.

Auto-pay claims process

When an accident or critical illness is related to a paid Short Term Disability claim, our claims management team also checks to see if the employee is enrolled in Accident Insurance or Critical Illness Insurance. If they are, and a claim hasn’t yet been filed, the claims team can automatically open a claim on the employee’s behalf and pay benefits for the covered events they’ve experienced.

Medical claims integration

Employers meeting specific criteria may be eligible to offer employees the option to get claims reminders based on medical claims data. Our carrier-agnostic medical claim integration is available for use with Supplemental Health Insurance products and can coordinate a broad range of medical plans.

*Critical Illness may be referred to as Specified Disease in some states.

 

Get more details about Voya Claims 360:

Voya Claims 360 Flyer

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The results speak for themselves

With Voya Claims 360, proactive notifications and claims processes support employee financial wellness when they experience covered events:

Claims benefits with integration1

  • 1,744 claims paid totaling $3.7 million

Total paid via STD-to-Supplemental Health claims integration and medical claims integration with Critical Illness, Accident & Hospital Indemnity Insurance (January 2021-December 2023)

Benefits paid after medical claims integration email2

  • 1,007 paid claims totaling $1.6 million

Total paid to employees who filed a claim within 90 days of receiving medical claims integration with Critical Illness, Accident & Hospital Indemnity Insurance (April 2021-December 2023)

Claims reminder emails sent

  • Number of reminders: 15,622

Based on our analysis of medical data and sent to 7,007 employees to remind them to submit a Supplemental Health claim (March 2021-December 2023)

1. Average Accident Insurance benefit amount paid from January 2021-December 2023 was $1,747. Average Hospital Confinement Indemnity Insurance benefit amount paid January 2021-December 2023 was $1,645. Average Critical Illness Insurance claim paid January 2021-December 2023 was $11,419. Actual results may vary.

2. MCI benefits paid out after email sent are included in Total Claims benefit.

Voya Claims 360 in action

Here are two real-life examples of how Claims 360 helps employees use their Supplemental Health benefits:

Jacob’s Claims 360 story

African American mature man smiling sitting at home relaxing

Jacob* took a bad fall at home and went to the emergency room

So, he submitted a Hospital Indemnity Insurance claim. A review of his claim and supporting documentation showed that Jacob fell accidentally and hit his head, which resulted in a concussion and some knee pain.

We then were able to see that he also had Accident Insurance — but he hadn’t filed a claim. As we processed the Hospital Indemnity claim we also opened an Accident claim. While we may sometimes notify an insured of an opportunity to file a claim, in this situation, no additional action was needed on Jacob’s part.

Jacob received eligible paid benefits under his Hospital Indemnity and Accident Insurance. While he hadn’t thought to file an Accident claim, our claims integration process enabled us to make sure he was receiving the benefits for which he was eligible under all of his active coverage.

He was able to recover comfortably at home — and the benefits he received helped lessen the financial impact of the accident on his budget.

*Name changed. Hospital Indemnity and Accident Insurance are limited benefit policies. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. “Hospital” is specifically defined in the certificate of insurance. This is an example that is based on an actual 2022 paid claim that utilized the HI-Accident claims integration process. It is provided for illustrative purposes only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. Actual results may vary.

Carrie’s Claims 360 story

An attractive young woman drinking coffee and relaxing at home

Carrie* had a heart attack and ended up in the hospital for a few days

She had Critical Illness Insurance, but at the time the claim was filed, we did not have enough records to support the Critical Illness claim. So, we pended it for additional medical records.

However, during our review, we saw that she also had Hospital Indemnity Insurance. The records we did have confirmed a three-day hospitalization — and that met the definition of a covered hospitalization under the provisions of her coverage. A Hospital Indemnity claim was opened automatically and approved for payment.

A week later, we received the additional information we needed that confirmed the diagnosis of a heart attack. We were then able to process the Critical Illness claim for benefit payment.

Carrie was able to recover comfortably at home — and the benefits she received minimized the financial impact of the out-of-pocket expenses she experienced due to her heart attack.

*Name changed. Critical Illness and Hospital Indemnity Insurance are limited benefit policies. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. This is an example that is based on an actual 2022 paid claim that utilized the claims integration process. It is provided for illustrative purposes only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. Actual results may vary.

Want to learn more about Voya Claims 360?

Talk to your Voya representative today.

A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. All coverage is subject to the terms and conditions of the group policy. If there is any discrepancy between this document and the group policy documents, the policy documents will govern. To keep coverage in force, premiums are payable up to the date of coverage termination. Insurance products are issued by ReliaStar Life Insurance Company (Minneapolis, MN) and ReliaStar Life Insurance Company of New York (Woodbury, NY). Within the State of New York, only ReliaStar Life Insurance Company of New York is admitted, and its products issued. Both are members of the Voya® family of companies. Voya Employee Benefits is a division of both companies. Product availability and specific provisions may vary by state and employer’s plan.

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