This PDF can be used to submit a claim for disability, cancer, accident, and hospital confinement.
This PDF should be used to submit a disability claim.
This PDF should be used to submit additional information for your
on-going disability claim.
This PDF should be used for the express filing of pregnancy claims once
you deliver. If you are filing for complications prior to delivery, please complete
the Universal Claim Form.
This PDF should be used to submit an accident claim.
If you are also filing for disability benefits, please complete the Disability claim form.
This PDF should be used for the express filing of health or wellness
screening claims that are over a year old..
This PDF should be used for the express filing of health and wellness screening
claims that are less than a year old OR you can login, go to the claims page
and file your claim online.
This PDF should be used to submit a cancer claim.
Submit online filing of doctor's office visit claims for Medical Bridge 3000 that are less than a year old.
This PDF should only be used to submit a claim form for a doctor's office visit if you have a Medical Bridge 3000 policy.
This PDF should be used to submit a claim for the critical illness benefit.
This PDF should be used to submit a claim under the Group Supplemental Hospital policy offered by your employer, if available where you work.
This PDF should be used to submit a claim for the catastrophic accident benefit.
This PDF should be completed and returned with each claim form submitted.
This PDF form should be used to add or modify the designated beneficiary on a policy.
This PDF form should be used to add or modify the designated beneficiary on a policy.
Use this PDF form to request changes to personal data, request a Beneficiary Change Form, or to exercise policy provisions.
This PDF form should be used to request a loan, withdrawal, or
cancellation/surrender of your life policy.
Submit Loss of Life Notification online.
Este formulario se usa para cambiar la designación de su beneficiario primario.
Este formulario se puede usar para procesar su reclamación.
Use este formulario para cambiar su dirección u otra información personal, cambiar su beneficiario o para efectuar otros cambios relacionados con su póliza.
This helpful flier provides information on finding the most up-to-date claim forms, submitting a claim and selecting optional services on the claim form. The form also provides helpful tips about the claims process, how the policy works and when to contact the service center.