HomeAbout UsInvestorsNewsroom SearchContact UsCareers
 
  Home > Claimants & Individuals > Assistance with Filing a Claim > Sample Disability Claim
 
  Disability Claim

 
Your disability benefits are intended to help support you while you are unable to work. It is important for us to understand your specific illness or injury so that we may help you in any way that is appropriate as you move through the stages of disability and on to recovery. To notify us of a disability income protection claim, you will need to complete a claim form, which is available through your employer, the insurance advisor who helped you buy a policy, or by calling toll free 800-858-6843. If your employer provides for telephone submission of claims, your employer will provide you with a toll-free number and specific instructions for calling in a claim.

The claim form includes everything you will need to initiate the processing of your claim, including:

  1. A statement from your attending physician
  2. Information the employer completes
  3. Information you complete
  4. An authorization form that enables us to gather additional information as it becomes necessary.

Click on the links below to view each section of a sample claim form with instructions for completing each area. If you have any additional questions, feel free to call us toll-free at 1-800-858-6843.

Sample form for short term disability claim request:

Back to top