Here are some tips to guide you through the process of filling out your critical illness claim — including important information and items to have on hand before you begin.

• All sections must be completed to ensure quicker processing.
• If this is your first time filing a critical illness claim, or you're filing a claim for a new diagnosis, gather copies of all the medical documentation that may be required for your condition:
  • Your name, date of birth, Social Security number (SSN) and address
  • Claimant's name date of birth, SSN (if other than primary insured)
  • Medical documentation for your condition
  • Diagnosis (ICD9) codes
  • Signed and dated authorization
  • Date of diagnosis
  • Primary doctor information and treating doctor information (if different)
  • Bills or proof of treatment for surgery, medical imaging, hospital stays, and other related out-of-pocket expenses
• If there was a hospital stay, include hospital bill with Date/Time admitted and Date/Time discharged or the Hospital Confinement Rehabilitation Confinement form.
• If surgery or a diagnostic procedure was performed, include the bill with procedure code of the Surgery/Diagnostic Procedure Form.
• If you have an optional rider for a health screening benefit or cancer vaccine benefit, you may be able to receive additional coverage for wellness or health screening tests.
• If you're also filing for disability insurance benefits, you'll need to submit a disability claim form as well.

Then, before you know it, you'll start receiving the benefits you need in less time than filing by paper.

For a paper form, download, print and fax the completed document to 1-800-880-9325 or mail to P.O. Box 100195, Columbia, SC 29202-3195.

Critical Illness claim form