For your convenience, claim and administrative forms can be found below. Please follow instructions included in the forms to submit your claim.

Forms by product

Disability/Paid Family & Medical Leave
Critical Illness/Specified Disease
Hospital Indemnity

Administrative forms

Benefits Continuation
Notice of Conversion
Portability Form - Life Insurance
Portability Form—Accident, Critical Illness/Specified Disease, and Hospital Indemnity
Assignment of Life Insurance

Still have questions?

We are here to help. If you have any questions about claims processing or need assistance with filling out a form, please give us a call.


Monday - Friday 8:00 AM - 8:00 PM ET

HIPAA  |  Legal

GE-6143095.1 (12/2023) (Exp. 12/2025)