If you're unable to file your claim online, download the multi-policy (universal) paper claim form and print it to file your claim by mail or fax.
Tips for filing a multi-policy claim by using the paper form
Here are some helpful tips to guide you through the claims process. If you would like more information, download the multi-policy (universal) claim form or watch the video below. It’s best to use the multi-policy claim form when you have when you have a claim that needs to be reviewed under two or more policies like: disability, accident, cancer, hospital confinement and surgery.
Use this form when filing under more than one policy.
- Check the type(s) of claim(s) you are filing and complete section 1.
- If you're filing for an accident, complete Section 2. The accident date and description are required when filing a universal claim.
- If you're filing for disability, have your employer complete Section 3 and your doctor complete Section 5 in their entirety.
- Have your doctor complete Sections 4A and 4B in their entirety, if applicable to your claim.
- Sign and date your claim form, and complete and sign the authorization page prior to filing.
To ensure faster filing, please include the following:
- A copy of the accident report (if you were in an auto accident)
- Any related itemized bills, including physician, ambulance, emergency room, hospital, and/or rehabilitation unit bills, along with diagnosis information, procedure codes, anesthesia, etc. from your medical provider