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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:
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A statement from your attending physician
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Information the employer completes
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Information you complete
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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:
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