State of Ohio

for what happens next

Download Forms
Download Forms

Formularios en Español

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Service Forms

Service Forms

To make it easy for you to access the forms you need, we have placed commonly used service forms on this site for you to access at your convenience.

These forms are available in Adobe Acrobat PDF format. The PDF forms must be printed out and then completed. They cannot be completed on-line. Once you have printed and completed the form, mail or fax the form to Colonial.
CLAIM FORMS
Colonial Life & Accident Insurance Company
P.O. Box 100195
Columbia, SC 29202-3195
FAX: 1-800-880-9325


OTHER FORMS
Colonial Life & Accident Insurance Company
P.O. Box 1365
Columbia, SC 29202-1365

To order forms that aren’t listed here, please call the Colonial Service Center at 1-800-325-4368.
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Download Forms

Form Title Description
Claim Form Use this PDF form to submit a claim.
Beneficiary Designation Form This PDF form should be used to add or modify the designated beneficiary on a policy.
Request For Service Use this PDF form to request changes to personal data, beneficiary, or to exercise policy provisions.
Wellness Claim Form Submit a wellness claim on-line.
Loss of Life (death) Notification Form Submit Loss of Life Notification on-line.
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Formularios en Español

Título Descripción
Formulario para la Designación de Beneficiario Este formulario se usa para designar un beneficiario primario o para seleccionar beneficiarios contingentes.
Formulario para la Presentación de una Reclamación Este formulario se puede usar para procesar su reclamación.
Formulario para Solicitar Servicio Use este formulario para cambiar su dirección u otra información personal, cambiar su beneficiario o para efectuar otros cambios relacionados con su póliza.
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Important Legal Notice
Privacy Policy
"Colonial Supplemental Insurance" and the logo, separately and in combination, and "for what happens next" are service marks of Colonial Life & Accident Insurance Company.

Colonial Supplemental Insurance products are underwritten by Colonial Life & Accident Insurance Company. Coverage has exclusions and limitations that may affect benefits payable. Coverage may vary by state and may not be available in all states. See your representative for complete details. Colonial Supplemental Insurance is the marketing brand of Colonial Life & Accident Insurance Company.