Please accept our condolences for your loss. We realize this is a difficult time for you and your family, and we will do our best to make sure your experience with us is caring, professional, and timely.

Once you have obtained and completed the necessary documents, you are ready to file your claim.

Obtain all documents and mail or fax to:

In order to file a claim for life insurance benefits, we require that you review and complete:

We understand that unforeseen circumstances can arise. As such, we offer a Premium Waiver program where you could have some, or all, of your life insurance premiums waived with the benefit amount of your coverage staying the same.

The instructions for submitting a Premium Waiver are as follows:

If you suffer a disability that keeps you from maintaining employment and this is the first time you are applying for premium waiver, please print and fill out the entire claim form and send it in along with your disability declaration letter from the Social Security office to the following address:

Click here for the printable claim form: Premium Waiver Claim Form

Once we receive the documentation, a Claims Analyst will review it and follow up with you regarding any potential assistance for which you are qualified.

Please note: If you qualify for Premium Waiver benefits, you will be required to provide continued proof of disability at regular intervals, which we will request in writing.

If you are filing a request for the continuance of Premium Waiver benefits, you need to complete the “Insured Information” section of the claim form and have your Physician complete the “Attending Physician’s Statement of Disability” (page 3). Please submit the completed documentation to the following address:

Click here for the printable claim form: Premium Waiver Claim Form

Once we receive the documentation, a Claims Analyst will review it and follow up with you regarding the continuance of your Premium Waiver benefits.

Please note: If you qualify for Premium Waiver benefits, you will be required to provide continued proof of disability at regular intervals, which we will request in writing. After two years of continued disability, we will not require such proof more than once a year.

Definition of Cancer:

Leukemia, Hodgkin's disease, or any form of malignant growth positively diagnosed as cancer (malignant neoplasm) by a legally licensed doctor of medicine certified by the American Board of Pathology or a certified Osteopathic Pathologist other than yourself or a member of your immediate family or household. Such diagnosis must be based on a biopic examination. The pathologist establishing the diagnosis shall base his judgment solely on the criteria of malignancy as accepted by the American Board of Pathology or the Osteopathic Board of Pathology. Pre-malignant conditions or conditions with malignant potential are not to be construed as cancer in interpreting this policy.

The following are not considered cancer for purposes of this policy:

For First Occurrence benefits, skin cancer is NOT covered unless it is considered a Melanoma.

Complete the Claimant Statement, HIPAA Release, Medical Provider History and provide a Pathology Report (click here for Pathology report examples ). Printable claim forms can be found below:

Please also include a copy of the CMS 1500 or UB-04 form (only associated with hospital stays) and any itemized medical bills you would like to have considered for payment. Examples can be found below:

If disability is being claimed, in addition to the documentation above, please have your employer fill out Part A and your physician fill out Part B on the Disability Claim Form. A printable form can be found here - Disability Claim Form .

Please mail the completed documentation to the following address:

Not considered cancer (examples)

• Carcinoma in Situ
• Stage 1 Hodgkin's disease
• Stage A Prostate Cancer
• Melanoma that is diagnosed as Clark's Level I or II or Breslow less than .75mm.

Definition of an Accident**:

Injury sustained by the insured, which is the direct result of an accident, occurring independently of disease, bodily infirmity, or any other cause while this policy is in force.

If Emergency Treatment is necessary, it must be received from: an emergency room; a hospital as an outpatient or as an inpatient for a period of twelve hours or less; a clinic; an ambulatory surgical center; or the office of a physician or surgeon. Such treatments must be received within 48 HOURS of the injury. (The State of Georgia allows 72 HOURS .)

**Definition of an accident may vary by policy.

Complete the Claimant Statement. Printable Claimant Statement can be found here - Claimant Statement

Please also include a copy of the CMS 1500 or UB-04 form (only associated with hospital stays) and any itemized medical bills you would like to have considered for payment. Examples can be found below:

If disability is being claimed, in addition to the documentation above, please have your employer fill out Part A and your physician fill out Part B on the Disability Claim Form. A printable form can be found here - Disability Claim Form .

Please mail the completed documentation to the following address:

Please note: If at any time during the review of your claim we find that we need additional information via medical narratives or a police report etc., we will notify you in writing.

You can receive your payment via direct deposit or by conventional mail. To sign up for direct deposit:

Definition of Hospital Intensive Care (ICU):

Those special intensive care areas of a hospital which at the time of your admission to the hospital are also separate and apart from the surgical recovery room and from the rooms, beds, and wards customarily used for patient confinement.

The term "intensive care unit" does NOT include lesser treatment units such as:

These units are classified on the UB-04 in the ‘Revenue Code ‘column and are not covered. Revenue Codes for lesser treatment units include but are not limited to the following: 0204, 0205, 0206, 0209, and 0214.

Please click on the sample to see where these codes are located on the UB-04 form: UB04 Sample - Revenue Codes

Complete the Claimant Statement, HIPAA Release, and Medical Provider History. Printable claim forms can be found below:

Please also include a copy of the CMS 1500 or UB-04 form (only associated with hospital stays) and any itemized medical bills you would like to have considered for payment. Examples can be found below:

If disability is being claimed, in addition to the documentation above, please have your employer fill out Part A and your physician fill out Part B on the Disability Claim Form. A printable form can be found here - Disability Claim Form .

Please mail the completed documentation to the following address:

Please note: We will examine each covered person(s) for our consideration of each person(s) pending claim. This will be done at the company's expense. If at any time during the review of your claim we find that we need additional information, we will notify you in writing.

Definition of a Heart Attack:

An acute myocardial infarction (the death of a portion of the heart muscle) resulting from a blockage of one or more coronary arteries. Cardiac arrest not caused by a myocardial infarction is not considered a heart attack for purposes of this policy, nor is any other disease or injury involving the cardiovascular system.

Your diagnosis must include ALL of the following:

Complete the Claimant Statement, HIPAA Release, and Medical Provider History. Printable claim forms can be found below:

Please also include a copy of the CMS 1500 or UB-04 form (only associated with hospital stays) and any itemized medical bills you would like to have considered for payment. Examples can be found below:

If disability is being claimed, in addition to the documentation above, please have your employer fill out Part A and your physician fill out Part B on the Disability Claim Form. A printable form can be found here - Disability Claim Form .

Please mail the completed documentation to the following address:

Please note: We will examine each covered person(s) for our consideration of each person(s) pending claim. This will be done at the company's expense. If at any time during the review of your claim we find that we need additional information, we will notify you in writing.

Complete the Claimant Statement. Printable Claimant Statement can be found here - Claimant Statement

Please also include a copy of the CMS 1500 or UB-04 form (only associated with hospital stays) and any itemized medical bills you would like to have considered for payment. Examples can be found below:

Definition of a Stroke:

A cerebrovascular incident caused by hemorrhage, embolism, thrombosis or infarction of brain tissue producing measurable neurological deficit persisting for at least thirty (30) days following the occurrence of such incident. We must receive evidence of permanent neurological damage from confirming neuroimaging studies.

The following conditions are not covered:

Complete the Claimant Statement, HIPAA Release, and Medical Provider History. Printable claim forms can be found below:

Please also include a copy of the CMS 1500 or UB-04 form (only associated with hospital stays) and any itemized medical bills you would like to have considered for payment. Examples can be found below:

If disability is being claimed, in addition to the documentation above, please have your employer fill out Part A and your physician fill out Part B on the Disability Claim Form. A printable form can be found here - Disability Claim Form .

Please mail the completed documentation to the following address:

Please note: We will examine each covered person(s) for our consideration of each person(s) pending claim. This will be done at the company's expense. If at any time during the review of your claim we find that we need additional information, we will notify you in writing.

Complete the Claimant Statement. Printable Claimant Statement can be found here - Claimant Statement

Please also include a copy of the CMS 1500 or UB-04 form (only associated with hospital stays) and any itemized medical bills you would like to have considered for payment. Examples can be found below:

We understand that unforeseen circumstances can arise. As such, we offer a Disability Benefit where, according to your policy benefit structure, you could be paid a specified amount.

If you suffer a disability that keeps you from maintaining employment and this is the first time you are applying for Disability, please print and fill out the claim form and send it to the following address:

Click here for the printable claim form: Disability Claim Form

Once we receive the documentation, a Claims Analyst will review it and follow up with you regarding any potential assistance for which you are qualified.

Please note: If you qualify for Disability benefits, you will be required to provide continued proof of disability at regular intervals, which we will request in writing.

If you are filing a request for the continuance of Disability benefits, you need to complete the Disability Claim Form. Remember to have your employer fill out Part A and your physician fill out Part B on the Disability Claim Form. Please submit the completed documentation to the following address:

Click here for the printable claim form: Disability Claim Form

Once we receive the documentation, a Claims Analyst will review it and follow up with you regarding the continuance of your Disability benefits.

Please note: If you qualify for Disability benefits, you will be required to provide continued proof of disability at regular intervals, which we will request in writing. After two years of continued disability, we will not require such proof more than once a year.