Disability Insurance: What Documents to Include with Claims

When filing a disability insurance claim, you will need to provide the following documentation:

• Statement of Insured, completed through your online account during the claim filing process
• Attending Physician Statement: The physician in charge of your care must complete this form. You can upload the form via your online account, or you can mail or fax it.
• Employer's Report of Claim: After your employer completes this form, you can upload the form via your online account, or you can mail or fax it. If applicable, your employer can upload the form themselves via their own online account.

If you're an employer, follow the instructions below to complete the Employer's Report of Claim form online:

1. 1. Log in to your portal account.
   2. Select the Claims page.
   3. Scroll or search for the employee you wish to complete the form for
   4. Click Need under the Employer Form column to start the process.

Note: The Employer's Report of Claim statement may not be required when filing for a routine pregnancy.

We may also need:

• Authorization to Disclose Information Including PHI: This form gives us authorization to get records from your medical provider(s) and others who may hold information necessary for us to review your claim. Upload the form via your online account, mail it in, or fax it.