Report a claim for critical, chronic, or terminal illness

Filing an Accelerated Death Benefit or Terminal Illness Rider claim

Please use the online form below to initiate an Accelerated Death Benefit or Terminal Illness Rider claim only if your policy has an Accelerated Death Benefit Rider or Terminal Illness Rider.

For additional policy and claim options, please refer to the Individual Claims page.

Check your policy contract, which was sent to you when your policy went into effect. Accelerated death benefit riders and terminal illness riders are provided under provisions that are called “policy riders.”

Any policy riders you have will be listed in the Policy Schedule section toward the front of the contract. If you have one or more Accelerated Death Benefit or Terminal Illness riders, they will be listed with these names:

Terminal Illness Accelerated Death Benefit Rider
Chronic Illness Accelerated Death Benefit Rider
Critical Illness Accelerated Death Benefit Rider
Terminal Illness Rider

The rider itself can be found toward the end of the policy document. It will list covered conditions for each type of illness. Check the rider language to verify your condition is covered.

We will verify your coverage and send you the appropriate claim form within 5 business days.

When all sections of the claim form are completed and signed, return it to the address provided on the form.

Please note:

One section of the claim form (Part C) will need to be completed and signed by the treating physician (or licensed healthcare practitioner) who diagnosed or certified the illness/condition for which the claim is being filed. This section is clearly marked on the form.
“Contestable” claims: Under industry standards, a policy is “contestable” if the condition is diagnosed within the 2-year period following the policy issue date or reinstatement date. If your policy is contestable, we will also provide you with a questionnaire that must be completed.

After we receive the completed and signed claim form, our Claims Department will obtain medical records from all of the listed medical care providers, as well as any other information needed to process the claim.

The amount of time it takes to review and approve the claim will vary depending on the number of health care providers we need to contact and how long it takes them to provide records.

Upon approval of the claim: We will send the policy owner notification of the approved dollar amount, which will be based on a percentage of the total policy benefit. Policy owners will have 60 days to complete and return the included election form to ensure prompt payment.

See our Frequently Asked Questions for additional information about critical illness, chronic illness, and terminal illness claims.

Report a claim for critical, chronic or terminal illness

Please only use this form to report a critical, chronic or terminal illness policy claim.

If the policy you are reporting is not a critical, chronic or terminal illness claim please refer to the other policy options on the Individual claims page.

*=Required

Critical, chronic or terminal illness policy number

Enter policy number below*

Type of illness/condition

What type of illness/condition are you filing a claim for? Please only select one.* Critical Chronic Terminal

Your information

Your role in this critical, chronic or terminal illness claim*

Select the Control (Ctrl) key to select more than one choice above.

First Name*

Middle Name

Last Name*

Mailing Address*

City*

State*

ZIP Code*

Email Address

Phone Number

Preferred method of contact Email Mail

Other parties to the claim (i.e. Beneficiary, etc)

Are you aware of any other parties/beneficiaries to this claim? If so, please provide their names and contact information.

Comments

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What else can we help you with?

Visit our support section if you require additional help with your inquiries or questions.

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Report a claim for critical, chronic, or terminal illness

How to verify your policy includes an Accelerated Death Benefit Rider or Terminal Illness Rider and that your condition is covered

After the claim is initiated using the online form