Online Claim Forms
Click the appropriate link and you will access an online form.
Click the appropriate link and you will access an online form.
Download onto computer. Forms can be filled out digitally using Adobe Acrobat or other PDF software but will not be fillable in most web browser preview windows.
NOTE: While the forms are “fillable,” they can not be submitted digitally unless you scan and email to the address provided on the form (If there is one).
Employer Guide to Naming a Life and AD&D Benificiary
Designation of Beneficiary Form
Life Accidental Death Claim Form
Additional AD&D Benefits Claim Form
Accidental Dismemberment or Specific Loss