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  FORMS




Group Life Insurance Claim Form - MedElite and MedElite Plus Only

Please follow the instructions on the form for quicker claim processing. Call 800-338-7452 for help in filing your claim.

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Group Life Insurance Beneficiary Designation Form - MedElite and MedElite Plus Only

If you would like to change Benefiiciaries download this Beneficiary Designation Form and complete it with the beneficiary designation you are choosing. The designation must be made, signed, and submitted to the below. We need to have this document on record prior to a death or a claim being filed. If there is no Beneficiary Designation on record any payable benefits remaining unpaid at the time of a Covered Person’s death may, at our option, be paid to a Covered Person’s next of kin or to a Covered Person’s estate. Make a copy for yourself to keep this document with your certificate and important papers.

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Accidental Death Benefit Claim Form - MedElite and MedElite Plus Only

Please follow the instructions on the form for quicker claim processing. Call 800-338-7452 for help in filing your claim.

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Group Accident Insurance Beneficiary Designation Form - MedElite and MedElite Plus Only

If you would like to change Benefiiciaries download this Beneficiary Designation Form and complete it with the beneficiary designation you are choosing. The designation must be made, signed, and submitted to the below. We need to have this document on record prior to a death or a claim being filed. If there is no Beneficiary Designation on record any payable benefits remaining unpaid at the time of a Covered Person’s death may, at our option, be paid to a Covered Person’s next of kin or to a Covered Person’s estate. Make a copy for yourself to keep this document with your certificate and important papers.

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Accidental Medical Benefit Claim Form - MedElite and MedElite Plus Only

Please follow the instructions on the form for quicker claim processing. Call 800-338-7452 for help in filing your claim.

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Cancer Lump Sum Benefit and Limited Specified Disease Benefit for Heart Attack and Stroke (Critical Illness) Claim Form - MedElite Plus Only

Please follow the instructions on the form for quicker claim processing. Call 800-338-7452 for help in filing your claim.

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Dismemberment & Loss of Sight Benefit Claim Form - MedElite and MedElite Plus Only

Please follow the instructions on the form for quicker claim processing. Call 800-338-7452 for help in filing your claim.

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Weekly Disability Claim Form - MedElite and MedElite Plus Only

Please follow the instructions on the form for quicker claim processing. Call 800-338-7452 for help in filing your claim.

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