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When you visit an in-network provider, you do not have to submit a claim. If you do choose to go out-of-network and your plan has out-of-network benefits, you will need to pay during the visit and then submit a claim for reimbursement. To access the out-of-network claim form, sign in to yourÌý.

ÐÔÊÀ½ç´«Ã½ is here to support you through challenging times with flexible options to start your claim. You can sign in to yourÌý or call us at (855) 810-3301. To help you prepare the necessary documents, you can also download the appropriate claim package and follow the instructions inside:

• Beneficiary Claim Package:ÌýFor use by a beneficiary or group life insured who has experienced a loss.ÌýFor BeneficiariesÌý|ÌýFor Employers
• Accelerated Benefit Option Package: For use by aÌýgroup life insured who has been diagnosed with a terminal illness and wants to receive a portion of their life insurance while living.ÌýFor EmployeesÌý|ÌýFor Employers
• Dismemberment Claim Package:ÌýFor use by aÌýgroup life insured with accidental death and dismemberment (AD&D) coverage who needs to file a claim for dismemberment due to an accident.ÌýFor EmployeesÌý|ÌýFor Employers
• Authorization for Release of Claim Information: For use by the claimant to designate an individual or entity to speak with ÐÔÊÀ½ç´«Ã½ on their behalf.ÌýFor Claimants
• Waiver of Premium While Totally Disabled Claim Package: For use by the claimant to have their premium waived while disabled.ÌýFor Claimants

With ÐÔÊÀ½ç´«Ã½, you can start a claim with the guided online process in yourÌýÌýor by calling us at (855) 810-3301. We use an innovative event-based approach to automatically create all applicable claims from one initial claim submission, ensuring we maximize your benefits. This saves you considerable time by eliminating the need to enter duplicate information. As you begin, it may be helpful to have certain information ready including names and contact information for doctors, treatment dates, and your last day worked.

You may also download theÌýGroup Disability Claim Statement Package.

With ÐÔÊÀ½ç´«Ã½, you can start a claim with the guided online process in yourÌýÌýor by calling us at (855) 810-3301. We use an innovative event-based approach to automatically create all applicable claims from one initial claim submission, ensuring we maximize your benefits. This saves you considerable time by eliminating the need to enter duplicate information. As you begin, it may be helpful to have certain information ready including names and contact information for doctors, treatment dates, and your last day worked.

You may also download theÌýGroup Disability Claim Statement Package.

With ÐÔÊÀ½ç´«Ã½, you can start a claim with the guided online process in yourÌýÌýor by calling us at (855) 810-3301. We use an innovative event-based approach to automatically create all applicable claims from one initial claim submission, ensuring we maximize your benefits. This saves you considerable time by eliminating the need to enter duplicate information.ÌýAs you begin, it may be helpful to have certain information ready including names and contact information for doctors and treatment dates.

You may also download theÌýGroup Accident Insured/Patient Claim Statement PackageÌýandÌýWellness Insured/Patient Claim Statement Package.Ìý

With ÐÔÊÀ½ç´«Ã½, you can start a claim with the guided online process in yourÌýÌýor by calling us at (855) 810-3301. We use an innovative event-based approach to automatically create all applicable claims from one initial claim submission, ensuring we maximize your benefits. This saves you considerable time by eliminating the need to enter duplicate information.ÌýAs you begin, it may be helpful to have certain information ready including names and contact information for doctors and treatment dates.

You may also download theÌýGroup Critical Illness Insured/Patient Claim Statement PackageÌýandÌýWellness Insured/Patient Claim Statement Package.Ìý

With ÐÔÊÀ½ç´«Ã½, you can start a claim with the guided online process in yourÌýÌýor by calling us at (855) 810-3301. We use an innovative event-based approach to automatically create all applicable claims from one initial claim submission, ensuring we maximize your benefits. This saves you considerable time by eliminating the need to enter duplicate information.ÌýAs you begin, it may be helpful to have certain information ready including names and contact information for doctors and treatment dates.

You may also download theÌýGroup Hospital Indemnity Insured/Patient Claim Statement PackageÌýandÌýWellness Insured/Patient Claim Statement Package.