Welcome to the Forms Library. Here you will find various forms pertaining to your insurance policies, ranging from applications, affidavits, questionnaires and premium waivers, claim statements, change of beneficiary and/or change of name, premium statements, manuals and other important documents.
Print out the forms you need, complete them and mail them to the address indicated on the form.
If you have difficulty locating the form you believe you need, and/or need assistance completing a form, please contact a Customer Service Representative at 1.866.975.4089.
Accelerated Benefit Claim Form Accidental Dismemberment Benefits Statement of Claim Attending Physician (to Be Completed by) Claimant’s Statement Enrollment for Life Insurance Forms Estate/Survivors Affidavit Questionnaire for Policyholders Filing Form 5500 Request for Change of Beneficiary/Name/Address Transfer to Minor Under UTMA Affidavit Waiver of Premium Benefits Form
Individual Disability/Accident/Critical Illness Insurance Claim Forms
Accident Insurance – Accident Claim Form Accident Insurance – Accidental Death Claim Form Authorization to Release Information Disability Income Claim Forms – Claimant & PhysiciansIn order to file a claim under the Disability Income Policy, the attached Claim Form must be completed in full. The policyholder must complete the Claimant section (pages 1–3) and the Authorization to Release form (page 5). The attending physician must complete the Attending Physician’s Initial Statement of Disability (pages 1–3). Once the form is complete, mail or fax it to the location indicated at the top of the form. An incomplete form, by ether claimant or attending physician, will delay processing. Critical Illness (Specified Disease) Insurance Claim Form
Medical Stop Loss
Excess Loss Insurance Application Supplementary Application Information Excess Loss Disclosure Form and Instructions for Completion Aggregate Excess Loss Proof of Loss Claim Form -ALASLCF-11 (CT) Specific Excess Loss Proof of Loss Claim Form Stop Loss Insurance Premium Statement