Opinion
No. 79 C 5160
May 3, 2002
AFFIDAVIT
Comes now the Affiant, CYNDI JUNGKUNTZ, being first duly sworn on oath, states as follows:
1. I am a Supervisor of Eligibility in the Group Administration Department of Bankers Life and Casualty Company and have held. that position for eight years. As a Supervisor of Eligibility in the Group Administration Department of Bankers Life and Casualty, I have responsibility for administering the group insurance program for the City of Chicago, including determining eligibility, processing deductions, and issuing certificates of insurance.
2. Bankers Life and Casualty Company provides life insurance coverage for certain City of Chicago employees under Master Group Policy No. 1802 issued by Bankers Life and Casualty Company to the City of Chicago. The insurance coverage includes Basic life insurance and Optional life insurance for those employees of the City of Chicago who make a written request for Optional life insurance on forms provided by Bankers Life and Casualty Company and for whom payroll deductions are made for the required contributions.
3. I have reviewed the records of Bankers Life and Casualty Company which records have been prepared and maintained by Bankers Life in the ordinary course of its business. Those records reveal that Anna Lewis, Social Security No. 268-22-9480, failed to submit a written request for Optional life insurance within 31 days after she became eligible for insurance under Group Policy No. 1802. Consequently, Optional insurance could only be issued to Anna Lewis upon her submission of evidence of insurability. Anna Lewis failed to submit evidence of her insurability and, therefore, Optional insurance for Anna Lewis never became effective.
4. Under the terms of Group Policy No. 1802, when an individual is on an authorized leave of absence granted by the City of Chicago for a non-duty related disability, the Basic life insurance of the employee may be continued for a period not to exceed four months by the employee making the required premium payments to Bankers Life and Casualty Company within 31 days from the date the Basic insurance would otherwise have ended, that is, on the last day of the employee's active service.
5. A review of the records of Bankers Life and Casualty Company reveals that Anna Lewis did not make any premium payments for her Basic life insurance coverage subsequent to her last day of active service.
6. I would testify to the aforementioned in a court of law if called upon to do so.
7. Further, Affiant sayeth not.
5/3/02 _______________ CYNDI JUNGKUNTZ