Claims forms
Find forms for life and group benefit claims.
Group benefits
Administration forms
Critical Illness - Claimant Statement
Direct Deposit Application - Disability Benefit Payments
Direct Deposit Application - Health Care or Dental Payments
Rehabilitation Earnings Statement
Notice of Death - Claimant Statement
Optional Accidental Death and Dismemberment Insurance Application
Optional Critical Illness Insurance Application
Optional Group Life Insurance Application
Over-Age Dependent Coverage Application
Other documents
Emergency Out of Country Coverage Booklet
Employer’s Guide to Disability Claims
Physician statement forms
Alzheimer's Disease or Dementia
Aortic Surgery, Coronary Angioplasty, Heart Valve Repair or Replacement
Critical Disease Physician Statement
Dismemberment Physician Statement
Kidney Failure (End Stage Renal Disease)
Major Organ Transplant and Major Organ Failure on Waiting List
Motor Neuron Disease or Multiple Sclerosis
Myocardial Infarction (Heart Attack)
Stroke or Cerebrovascular Accident (CVA)
Attending physician statements
Early Intervention for Mental Health Conditions
Initial Disability Insurance Medical Statement
Long Term Disability for Mental Health Conditions
Short Term Disability for Mental Health Conditions
Dependent children covered illness
Plan member forms
Plan sponsor forms