RFP%2031786-00193%20Appendix%207.16%20Basic%20Term%20Life%20Waiver%20of%20Premium%20Claims%20History%202018%20%E2%80%93%20June%202026.xlsx

XLSX spreadsheet 176 KB Posted Aug 20, 2026

Attached to: Life and Accidental Death and Dismemberment Insurance - UPDATED
Solicitation number: RFP 31786-00193
Issued by: Davidson County, Tennessee

About this file

Written by GovTribe AI · Aug 21, 2026

This file is a Basic Term Life Waiver of Premium Claims History document for Policy Number 34294 under RFP 31786-00193, covering participating basic life insurance claims experience for the State of Tennessee from January 2018 through June 2026. The document provides a comprehensive record of approved waiver of premium claims spanning eight and one-half years, detailing individual claim information including claim numbers, claimant ages and genders, dates of onset, dates of notice, and approved reserve amounts. The claims data is organized by calendar year, with 2018 showing 54 total claims, 2019 showing 68 total claims, 2020 showing 12 total claims, 2021 showing 23 total claims, 2022 showing 28 total claims, 2023 showing 2 total claims (January through September), 2024 showing 9 total claims, 2025 showing 16 total claims, and the first half of 2026 showing 23 total claims. Reserve amounts per individual claim generally range from $8,000 to $38,000, with most claims approved at $20,000.

The document demonstrates significant claims activity and reserve management across the benefit period. The 2018 year-end reserve totaled $946,200, increasing to $1,164,200 by year-end 2019, representing a change in reserve of $613,400 for 2018 and $218,000 for 2019. The claims data indicates ongoing disability benefit administration with claimants spanning a wide age range from 39 to 59 years old at the time of claim approval. The historical claims experience reflected in this appendix would serve as critical underwriting and actuarial data for evaluating the cost and experience of the basic term life waiver of premium benefit under Tennessee's group life insurance program.

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File	Type	Posted
RFP_31786-00193_Appendix_7.28.pdf	PDF	Oct 14, 2026
RFP_31786-00193_Appendix_7.30.xlsx	XLSX spreadsheet	Oct 14, 2026
RFP_31786-00193_Life_and_ADD_RFP_Release_2.docx	DOCX document	Oct 14, 2026
RFP_31786-00193_Appendix_7.27.pdf	PDF	Oct 14, 2026
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RFP_31786-00193_Amendment_Two.docx	DOCX document	Oct 14, 2026
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RFP_31786-00193_Appendix_7.25.xlsx	XLSX spreadsheet	Oct 14, 2026
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RFP_31786-00193_Amendment_One_Schedule_Update.docx	DOCX document	Oct 2, 2026
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31786-00193_Digital_Submission_Instructions.docx	DOCX document	Aug 20, 2026
RFP%2031786-00193%20Appendix%207.4%20Enrollment%20and%20Coverage%20in%20Basic%20Term%20Life%20and%20Basic%20ADD%202018%20-%20June%202026.xlsx	XLSX spreadsheet	Aug 20, 2026
RFP%2031786-00193%20Appendix%207.17%20Voluntary%20Term%20Life%20Waiver%20of%20Premium%20Claims%20History%202018%20%E2%80%93%20June%202026.xlsx	XLSX spreadsheet	Aug 20, 2026
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RFP 31786-00193 Appendix 7.16 Basic Term Life Waiver of Premium Claims History 2018 – June 2026

Participating Basic Life Insurance Claims Experience Policy Number: 34294

For the Period January 1, 2018 through December 31, 2018 Estimate Approved Waiver of Premium Claims

	Claim Number			Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

	D071300	57	F	01/31/2014	10/27/2014	$	20,000
	D072205	58	F	01/22/2014	12/31/2014		19,000
	D072206	57	F	03/31/2014	12/31/2014		20,000
	D073263	58	M	03/18/2014	03/09/2015		12,000
	D073358	48	F	10/17/2014	03/16/2015		20,000
	D073829	54	M	04/11/2014	04/13/2015		14,800
	D075028	59	M	11/20/2014	07/08/2015		20,000
	D075674	50	F	09/29/2014	08/14/2015		8,800
	D077648	48	F	12/14/2014	01/06/2016		17,600
	D078229	49	F	03/05/2015	02/24/2016		20,000
	D080598	58	M	01/01/2016	08/17/2018		20,000
	D081379	53	F	12/06/2014	09/09/2016		19,000
	D084052	51	F	10/04/2016	03/28/2017		17,600
	D086068	58	M	08/01/2016	06/26/2017		20,000
	D086089	50	F	08/10/2016	06/29/2017		20,000
	D087190	57	M	04/02/2017	09/15/2017		20,000
	D087235	52	F	02/25/2016	09/15/2017		20,000
	D087521	58	F	08/20/2016	09/22/2017		20,000
	D087527	55	F	06/18/2016	09/22/2017		8,000
	D087899	44	F	09/01/2016	09/29/2017		20,000
	D087900	49	F	07/01/2016	09/29/2017		16,200
	D088251	48	F	11/22/2016	10/17/2017		20,000
	D088252	56	M	09/22/2016	10/17/2017		17,600
	D088254	53	F	10/02/2016	10/18/2017		20,000
	D088305	59	F	01/28/2017	10/20/2017		20,000
	D088308	49	F	12/06/2016	10/20/2017		20,000
Participating Basic Life Insurance Claims Experience Policy Number: 34294

For the Period January 1, 2018 through December 31, 2018 Estimate Approved Waiver of Premium Claims

	Claim Number			Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D089310	54	F	03/07/2016	12/08/2017	$	20,000
D089499	51	F	08/17/2016	12/22/2017		20,000
D089625	56	F	11/05/2016	01/05/2018		20,000
D090032	47	F	02/02/2017	01/19/2018		17,600
D091530	53	M	02/04/2017	03/23/2018		13,400
D091554	52	F	03/21/2017	03/23/2018		20,000
D092037	50	M	03/28/2017	04/13/2018		20,000
D092074	46	M	03/09/2017	04/13/2018		13,400
D092086	50	F	04/26/2017	04/13/2018		20,000
D092088	59	F	06/01/2017	04/13/2018		20,000
D092215	49	M	04/19/2017	04/20/2018		20,000
D092300	58	M	05/19/2017	04/27/2018		19,000
D092659	39	M	07/14/2017	05/21/2018		20,000
D092667	52	F	07/01/2017	05/11/2018		20,000
D092697	50	F	06/25/2017	05/11/2018		10,000
D092867	46	M	06/26/2014	05/18/2018		8,000
D092876	53	F	04/06/2014	05/18/2018		20,000
D093089	50	M	08/22/2017	06/01/2018		8,000
D093096	59	M	09/01/2017	06/01/2018		20,000
D093400	45	F	11/09/2016	06/15/2018		17,600
D094004	48	F	11/24/2016	07/13/2018		20,000
D094053	58	F	08/06/2017	07/13/2018		14,800
D094104	59	M	06/30/2017	07/13/2018		16,200
D094230	54	F	08/05/2017	07/20/2018		13,400
D094255	57	F	09/16/2017	07/20/2018		16,200
D095001	44	M	11/01/2017	08/24/2018		20,000

Participating Basic Life Insurance Claims Experience Policy Number: 34294 For the Period January 1, 2018 through December 31, 2018 Estimate

	Approved Waiver of Premium Claims
		Claim Number			Age	Gender	Date of
Onset			Date of
Notice				Approved

Reserve

	D095021	56	M	10/26/2017	08/24/2018	$ 20,000
	D095023	54	F	05/23/2017	08/24/2018	8,000
12/31/18 Reserve: $ 946,200
12/31/17 Reserve: $ (332,800)
54 Total Claims Change in Reserve: $ 613,400

Participating Basic Life Insurance Claims Experience Policy Number: 34294 For the Period January 1, 2019 through December 31, 2019 Estimate Approved Waiver of Premium Claims

	Claim Number		Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D071300	57	F	01/31/2014	10/27/2014	$	20,000
D072205	58	F	01/22/2014	12/31/2014		19,000
D073263	58	M	03/18/2014	03/09/2015		12,000
D073358	48	F	10/17/2014	03/16/2015		20,000
D073829	54	M	04/11/2014	04/13/2015		14,800
D075028	59	M	11/20/2014	07/08/2015		20,000
D075674	50	F	09/29/2014	08/14/2015		8,800
D077648	48	F	12/14/2014	01/06/2016		17,600
D078229	49	F	03/05/2015	02/24/2016		20,000
D080598	58	M	01/04/2016	08/17/2018		20,000
D084052	51	F	10/04/2016	03/28/2017		17,600
D086068	58	M	08/01/2016	06/26/2017		20,000
D086089	50	F	08/10/2016	06/29/2017		20,000
D087190	57	M	04/02/2017	09/15/2017		20,000
D087235	52	F	02/25/2016	09/15/2017		20,000
D087521	58	F	08/20/2016	09/22/2017		20,000
D087527	55	F	06/18/2016	09/22/2017		8,000
D087899	44	F	09/01/2016	09/29/2017		20,000
D088252	56	M	09/22/2016	10/17/2017		17,600
D088254	53	F	10/02/2016	10/18/2017		20,000
D088305	59	F	01/28/2017	10/20/2017		20,000
D088308	49	F	12/06/2016	10/20/2017		20,000
D089310	54	F	03/07/2016	12/08/2017		20,000
D089499	51	F	08/17/2016	12/22/2017		20,000
D089625	56	F	11/05/2016	01/05/2018		20,000
D090032	47	F	02/02/2017	01/19/2018		17,600
D091554	52	F	03/21/2017	03/23/2018		20,000
D092037	50	M	03/28/2017	04/13/2018		20,000
D092074	46	M	03/09/2017	04/13/2018		13,400
Participating Basic Life Insurance Claims Experience Policy Number: 34294

For the Period January 1, 2019 through December 31, 2019 Estimate Approved Waiver of Premium Claims

	Claim Number		Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D092086	50	F	04/26/2017	04/13/2018	$	20,000
D092215	49	M	04/19/2017	04/20/2018		20,000
D092300	58	M	05/19/2017	04/27/2018		19,000
D092656	58	F	02/14/2017	05/11/2018		8,000
D092659	39	M	07/14/2017	05/21/2018		20,000
D092667	52	F	07/01/2017	05/11/2018		20,000
D092697	50	F	06/25/2017	05/11/2018		10,000
D092867	46	M	06/26/2014	05/18/2018		8,000
D092876	53	F	04/06/2014	05/18/2018		20,000
D093089	50	M	08/22/2017	06/01/2018		8,000
D093096	59	M	09/01/2017	06/01/2018		20,000
D093400	45	F	11/09/2016	06/15/2018		17,600
D094004	48	F	11/24/2016	07/13/2018		20,000
D094041	52	F	02/20/2017	07/13/2018		17,600
D094042	46	F	09/13/2016	07/13/2018		20,000
D094053	58	F	08/06/2017	07/13/2018		14,800
D094104	59	M	06/30/2017	07/13/2018		16,200
D094140	38	M	08/09/2017	07/13/2018		20,000
D094230	54	F	08/05/2017	07/20/2018		13,400
D094255	57	F	09/16/2017	07/20/2018		16,200
D095001	44	M	11/01/2017	08/24/2018		20,000
D095021	56	M	10/26/2017	08/24/2018		20,000
D095023	54	F	05/23/2017	08/24/2018		8,000
D095386	47	F	10/25/2017	02/15/2019		8,000
D096917	46	F	04/19/2018	11/09/2018		8,000
D097704	55	F	04/12/2018	12/14/2018		19,000
D097705	54	M	12/01/2017	12/14/2018		8,000
D098197	49	M	01/27/2018	01/11/2019		20,000
D098554	53	F	03/26/2018	01/25/2019		20,000
Participating Basic Life Insurance Claims Experience Policy Number: 34294

For the Period January 1, 2019 through December 31, 2019 Estimate Approved Waiver of Premium Claims

	Claim Number		Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D098860	52	M	01/30/2018	02/08/2019	$	20,000
D099558	52	M	01/21/2018	03/08/2019		17,600
D099583	49	M	04/05/2018	03/08/2019		20,000
D099591	48	F	04/05/2018	03/08/2019		20,000
D099679	49	M	04/03/2018	03/15/2019		20,000
D099683	54	M	04/15/2018	03/15/2019		20,000
D099689	56	F	02/27/2018	03/15/2019		20,000
D099838	56	M	07/11/2018	03/22/2019		8,000
D099854	50	F	06/07/2018	03/22/2019		19,000
D099979	55	M	05/23/2018	03/29/2019		13,400
				12/31/19 Reserve: $		1,164,200
				12/31/18 Reserve: $		(946,200)
	68	Total Claims		Change in Reserve:	$	218,000

Participating Basic Life Insurance Claims Experience Policy Number: 34294 For the Period January 1, 2020 through December 31, 2020 Estimate Approved Waiver of Premium Claims

	Claim Number			Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D105511	59	F	10/29/2019	10/21/2020	$	20,000
D106867	53	F	08/01/2019	06/15/2020		16,200
D107305	51	F	09/25/2019	02/25/2020		20,000
D109009	59	F	06/28/2019	05/22/2020		19,000
D109475	56	F	07/18/2019	06/12/2020		20,000
D109530	55	M	06/17/2019	06/17/2020		20,000
D110050	58	M	06/25/2019	07/17/2020		20,000
D110051	50	F	11/05/2019	07/17/2020		20,000
D110845	50	M	10/31/2019	08/31/2020		12,000
D111390	51	F	09/19/2019	09/21/2020		20,000
D111420	56	M	08/03/2019	09/25/2020		20,000
D111769	54	M	06/10/2019	10/09/2020		14,800
	12	Total Claims			$	222,000

Participating Basic Life Insurance Claims Experience Policy Number: 34294 For the Period January 1, 2021 through December 31, 2021 Estimate Approved Waiver of Premium Claims

	Claim Number			Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D109475	56	F	07/18/2019	06/12/2020	$	20,000
D115315	49	F	02/28/2020	03/19/2021		14,800
D105511	59	F	10/29/2019	10/21/2020		20,000
D115285	48	M	04/30/2020	03/17/2021		19,000
D111420	56	M	08/03/2019	09/25/2020		20,000
D111713	41	M	10/29/2019	10/06/2020		17,600
D110050	58	M	06/25/2019	07/17/2020		20,000
D109530	55	M	06/17/2019	06/17/2020		20,000
D111390	51	F	09/19/2019	09/21/2020		20,000
D118150	54	F	09/22/2020	08/06/2021		20,000
D116145	51	F	08/07/2019	04/28/2021		20,000
D110051	50	F	11/05/2019	07/17/2020		20,000
D111769	54	M	06/10/2019	10/09/2020		14,800
D106867	53	F	07/10/2019	06/15/2020		16,200
D111712	48	F	07/31/2019	10/05/2020		20,000
D109009	59	F	06/28/2019	05/22/2020		19,000
D115869	58	M	06/06/2020	04/14/2021		20,000
D109745	58	M	05/15/2020	06/29/2020		19,000
D114703	52	M	10/24/2019	02/19/2021		8,000
D110845	50	M	10/31/2019	08/31/2020		12,000
D107487	56	F	08/23/2019	03/02/2020		14,800
D115820	57	M	06/15/2019	04/13/2021		17,600
D107305	51	F	09/25/2019	02/25/2020		20,000
		Total Claims	23		$	412,800

Participating Basic Life Insurance Claims Experience Policy Number: 34294 For the Period January 1, 2022 through December 31, 2022 Estimate Approved Waiver of Premium Claims

	Claim Number			Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D105511	59	F			10/29/2019	10/21/2020	$	20,000
D106867	53	F			07/10/2019	06/15/2020		16,200
D107305	51	F			09/25/2019	02/25/2020		20,000
D107487	56	F			08/23/2019	03/02/2020		14,800
D109009	59	F			06/28/2019	05/22/2020		19,000
D109475	56	F			07/18/2019	06/12/2020		20,000
D109530	55	M			06/17/2019	06/17/2020		20,000
D109745	58	M			05/15/2020	06/29/2020		19,000
D110050	58	M			06/25/2019	07/17/2020		20,000
D110051	50	F			11/05/2019	07/17/2020		20,000
D110845	50	M			10/31/2019	08/31/2020		12,000
D111390	51	F			09/19/2019	09/21/2020		20,000
D111712	48	F			07/31/2019	10/05/2020		20,000
D111713	41	M			10/29/2019	10/06/2020		17,600
D111769	54	M			06/10/2019	10/09/2020		14,800
D114703	52	M			10/24/2019	02/19/2021		8,000
D115285	48	M			04/30/2020	03/17/2021		19,000
D115869	58	M			06/06/2020	04/14/2021		20,000
D116145	51	F			08/07/2019	04/28/2021		20,000
D118150	54	F			09/22/2020	08/06/2021		20,000
D120971	57	F			02/28/2020	12/10/2021		20,000
D121297	58	F			02/10/2021	12/27/2021		20,000
D121596	55	F			05/11/2021	01/14/2022		20,000
D122234	56	F			04/05/2021	02/14/2022		20,000
D123149	51	F			11/30/2020	03/28/2022		8,000
D123365	58	M			07/16/2021	04/06/2022		20,000
D123373	58	F			10/08/2021	04/06/2022		20,000
D123421	52	M			05/31/2021	04/11/2022		20,000
			Total Claims	28					$508,400.00

2023 (old) Participating Basic Life Insurance Claims Experience Policy Number: 34294 For the Period January 1, 2023 through December 31, 2023 Estimate Approved Waiver of Premium Claims

	Claim Number		Age		Gender	Date of
Onset				Date of
Notice		Approved

Reserve

D105511	59		F	10/29/2019	10/21/2020	$	$20,000
D106867	53		F	07/10/2019	06/15/2020		$16,200
D107305	51		F	09/25/2019	02/25/2020		$20,000
D107487	56		F	08/23/2019	03/02/2020		$14,800
D109009	59		F	06/28/2019	05/22/2020		$19,000
D109530	55		M	06/17/2019	06/17/2020		$20,000
D109745	58		M	05/15/2020	06/29/2020		$19,000
D110050	58		M	06/25/2019	07/17/2020		$20,000
D110051	50		F	11/05/2019	07/17/2020		$20,000
D110845	50		M	10/31/2019	08/31/2020		$12,000
D111390	51		F	09/19/2019	09/21/2020		$20,000
D111712	48		F	07/31/2019	10/05/2020		$20,000
D111769	54		M	06/10/2019	10/09/2020		$14,800
D114703	52		M	10/24/2019	02/19/2021		$8,000
D115285	48		M	04/30/2020	03/17/2021		$19,000
D115869	58		M	06/06/2020	04/14/2021		$20,000
D116145	51		F	08/07/2019	04/28/2021		$20,000
D118150	54		F	09/22/2020	08/06/2021		$20,000
D119206	54		M	11/14/2020	10/01/2021		$20,000
D120971	57		F	02/28/2020	12/10/2021		$20,000
D121297	58		F	02/10/2021	12/27/2021		$20,000
D121596	55		F	05/11/2021	01/14/2022		$20,000
D122234	56		F	04/05/2021	02/14/2022		$20,000
D123365	58		M	07/16/2021	04/06/2022		$20,000
D123373	58		F	10/08/2021	04/06/2022		$20,000
D123421	52		M	05/31/2021	04/11/2022		$20,000
D123825	53		M	11/01/2020	05/02/2022		$16,200
D123854	52		F	10/11/2021	05/04/2022		$20,000
	Total Claims	28						$519,000

2023 (new) Participating Basic Life Insurance Claims Experience Policy Number: 34294 For the Period January 1, 2023 through September 30, 2023 Estimate

	Approved Waiver of Premium Claims
	Claim Number			Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D132750	58	M	01/04/2023	09/08/2023	$ 20,000
D133776	49	M	03/14/2023	11/03/2023	20,000
2 Total Claims $ 40,000

Participating Basic Life Insurance Claims Experience Policy Number: 34294 For the Period January 1, 2024 through December 31, 2024 Estimate Approved Waiver of Premium Claims

	Claim Number			Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D132750	58	M	01/04/2023	09/08/2023	$	20,000
D132882	53	F	07/27/2023	09/14/2023		20,000
D134445	57	F	03/31/2023	12/06/2023		20,000
D134481	55	F	04/15/2023	12/08/2023		20,000
D136204	48	M	03/05/2023	03/06/2024		20,000
D137162	56	F	09/12/2023	05/03/2024		20,000
D137164	46	F	02/28/2023	05/03/2024		20,000
D138168	58	M	11/28/2023	07/03/2024		20,000
D138718	40	F	12/31/2023	08/02/2024		20,000
	9	Total Claims			$	180,000

Participating Basic Life Insurance Claims Experience Policy Number: 34294 For the Period January 1, 2025 through December 31, 2025 Estimate Approved Waiver of Premium Claims

	Claim Number			Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D132750	58	M	01/04/2023	09/08/2023	$	20,000
D132882	53	F	07/27/2023	09/14/2023		20,000
D134445	57	F	03/31/2023	12/06/2023		20,000
D136204	48	M	03/05/2023	03/06/2024		20,000
D136205	55	F	08/16/2023	03/06/2024		20,000
D137162	56	F	09/12/2023	05/03/2024		20,000
D137164	46	F	02/28/2023	05/03/2024		20,000
D138718	40	F	12/31/2023	08/02/2024		20,000
D140505	54	F	01/31/2024	11/18/2024		26,400
D140507	50	F	03/31/2024	11/18/2024		38,000
D141292	52	F	05/02/2024	01/03/2025		20,000
D141294	58	F	05/31/2024	01/03/2025		20,800
D141721	54	M	06/01/2024	02/03/2025		22,400
D141722	56	M	06/03/2024	02/03/2025		22,000
D143931	46	F	10/18/2024	06/03/2025		20,000
D144531	57	M	11/22/2024	07/01/2025		22,000
	16	Total Claims			$	351,600

2026 Q2 Participating Basic Life Insurance Claims Experience Policy Number: 34294 For the Period January 1, 2026 through June 30, 2026 Estimate Approved Waiver of Premium Claims

	Claim Number			Age	Gender	Date of
Onset		Date of
Notice			Approved

Reserve

D132750	58	M	01/04/2023	09/08/2023	$	20,000
D132882	53	F	07/27/2023	09/14/2023		20,000
D134445	57	F	03/31/2023	12/06/2023		20,000
D136204	48	M	03/05/2023	03/06/2024		20,000
D136205	55	F	08/16/2023	03/06/2024		20,000
D137162	56	F	09/12/2023	05/03/2024		20,000
D137164	46	F	02/28/2023	05/03/2024		20,000
D138718	40	F	12/31/2023	08/02/2024		20,000
D140505	54	F	01/31/2024	11/18/2024		26,400
D140507	50	F	03/31/2024	11/18/2024		38,000
D141292	52	F	05/02/2024	01/03/2025		20,000
D141294	58	F	05/31/2024	01/03/2025		20,800
D141721	54	M	06/01/2024	02/03/2025		22,400
D141722	56	M	06/03/2024	02/03/2025		22,000
D143533	51	M	09/04/2024	05/13/2025		36,000
D143931	46	F	10/18/2024	06/03/2025		20,000
D144531	57	M	11/22/2024	07/01/2025		22,000
D144963	50	F	01/06/2025	08/04/2025		28,400
D145552	53	F	01/27/2025	09/03/2025		20,000
D147135	58	M	04/25/2025	12/01/2025		22,000
D147804	45	M	05/23/2025	01/06/2026		20,000
D148306	49	F	06/09/2025	02/06/2026		30,800
D148789	44	F	07/17/2025	03/04/2026		20,400
	23	Total Claims			$	529,200

File details come from the government source that posted it. Updated Aug 21, 2026.