File a Claim

To file a claim, please select a product from the drop-down list to choose the right claim form.
New York policyholders find claim forms here.

Notice: In order to provide the quickest service; to file a claim benefit for Wellness, Health Screening, or Healthy Living Riders please make sure you use the appropriate claim form.

 

Life Insurance Claim Information

Download a PDF claim form for:

Please submit claim documentation using either of the following:

Questions? Contact us.

Accident Claim Information

Download a PDF claim form for:

Please submit claim documentation using any of the following:

For a Wellness Rider claim, please send the following to Trustmark:

Please submit claim documentation using any of the following:

For a Health Screening Rider claim (only available on plans 4, 5 and 6), please send the following to Trustmark:

Please submit claim documentation using any of the following:

Questions? Contact us.

Critical Illness and Cancer Claim Information

Download a PDF claim form for:

Please submit claim documentation using any of the following:

For a Health Screening Rider claim, please send the following to Trustmark:

Please submit claim documentation using any of the following:

Questions? Contact us.

Trustmark Critical HealthEvents® Claim Information

Download a PDF claim form for:

Please submit claim documentation using any of the following:

For a Healthy Living Rider claim, please send the following to Trustmark:

Please submit claim documentation using any of the following:

Questions? Contact us.

Disability Claim Information

Download the appropriate PDF claim form for disability insurance.

If your disability is related to pregnancy, regardless of where you purchased your disability insurance, use this claim form:

  • Pregnancy disability claim form
    • Note: Please do not submit your claim form until after your last day of work or after the date of your delivery. We will be unable to process your claim if you are still working.

If you purchased Disability insurance from a representative at your place of employment, use this claim form:

For continuing claims, use this claim form:

Please submit claim documentation using any of the following:

Questions? Contact us.

Hospital Confinement Claim Information

Download a PDF claim form for:

Please submit claim documentation using any of the following:

Questions? Contact us.

Dental Claim Information

Download a PDF claim form for:

Questions? Contact us.