CL-1088 | Authorization HIPAA Disability Claim |
CL-1088-SP | Authorization HIPAA Disability Claim - Spanish |
CL-1108 | Authorization HIPAA Individual Disability Claim |
CL-1108-SP | Authorization HIPAA Individual Disability Claim - Spanish |
CL-1250 | Authorization HIPAA VB Claim (Patient) |
CL-1116 | Authorization HIPAA VB Disability Claim |
CL-1116-SP | Authorization HIPAA VB Disability Claim - Spanish |
CL-1021 | Claim - Disability Status Update Form |
CL-1023 | Claim - Accident Insurance |
CL-1023-BL | Claim - Accident Insurance - Bilingual |
CL-1099 | Claim - Authorization - Accelerated Life or Dismemberment |
CL-1300 | Claim - Chronic Care |
CL-1129 | Claim - Continuation of Group Life Insurance for Incapacitated Children |
CL-1092 | Claim - Group Accidental Dismemberment |
CL-1161 | Claim - Group Hospital Indemnity |
CL-1161-BL | Claim - Group Hospital Indemnity - Bilingual |
CL-1093 | Claim - Group Life Accelerated Benefit |
CL-1103 | Claim - Group Life Accelerated Benefit for Life Waiver |
CL-1091 | Claim - Group Life and/or Accidental Death |
CL-1091-SP | Claim - Group Life and/or Accidental Death - Spanish |
CL-1336 | Claim - Group Whole Life Employer Statement |
CL-1020 | Claim - IDI Disability |
CL-1020-ASC | Claim - IDI Disability - Association |
CL-1020-NYL | Claim - IDI Disability - New York Life |
CL-1335 | Claim - Immediate Advance Payment |
CL-1027 | Claim - Individual Disability Status Update Form |
CL-1027-ASC | Claim - Individual Disability Status Update Form - Association |
CL-1027-NYL | Claim - Individual Disability Status Update Form - New York Life |
CL-1060 | Claim - Leave Request Form |
CL-1019 | Claim - LTD Disability |
CL-1019-BL | Claim - LTD Disability (Bilingual) |
CL-1022 | Claim - MedSupport |
CL-1101 | Claim - Portability Group Accidental Dismemberment |
CL-1102 | Claim - Portability Group Life Accelerated Benefit |
CL-1100 | Claim - Portability Life and/or Accidental Death |
CL-1100-BL | Claim - Portability Life and/or Accidental Death - Billingual |
CU-3918 | Claim - Select Educator Protection - MGM |
CL-1058-CCR | Claim - VB - Authorization to Disclose Info to Third Parties (Chronic Care Rider) |
CL-1058-CS | Claim - VB - Authorization to Disclose Info to Third Parties (claimant signature) |
CL-1058-IPS | Claim - VB - Authorization to Disclose Info to Third Parties (insured patient signature) |
CL-1058-PS | Claim - VB - Authorization to Disclose Info to Third Parties (patient signature) |
CL-1058-PHS | Claim - VB - Authorization to Disclose Info to Third Parties (policyholder signature) |
CL-1018 | Claim - VB Cancer/Critical Illness |
CL-1090 | Claim - VB Health Screening/Wellness Benefit |
CL-1061 | Claim - VB Notice of Life Insurance Form |
CL-1064 | Claim - Voluntary Benefits Disability |
CL-1064-BL | Claim - Voluntary Benefits Disability - Bilingual |
1130-00-NY | Claim DB-450 Reimbursement - First Unum |
CL-1197 | Claim Form - Be Well |
CL-1198 | Claim Form - Group Critical Illness |
CL-1198-BL | Claim Form - Group Critical Illness - Bilingual |
CL-1104 | Claim Form - Short Term Disability |
CL-1104-BL | Claim Form - Short Term Disability (Bilingual) |
CL-1179 | Claim Form - VB LTC |
CL-1074 | Claim Form - VB Supplemental Statement |
CL-1323 | Claim Hospital Confinement |
CL-1299 | Claim LTD - Spouse Disability |
CL-1299-SPS | Claim LTD - Spouse Disability - Spouse Statement |
1165-04 | Claim Portability - Death |
CL-1296 | Claim Select Income Protection |
97210 | First Unum Claim Form and Instructions - *REQUIRED |
CL-1190 | Group Dental Claim Form |
CL-1234 | Group Life - Disability Benefit Claim Form |
CL-1310 | Life Accelerated Benefit Claim Form |
NY 1474-96 | Portability Group Life/AD&D Claim Form - New York |
NY1343-99 | Short Term Disability Claim Form - Required For New Jersey Employees |
MK-1252 | Submitting a Disability Claim employee flyer |
CL-1252 | Unum DHMO dental claim form |
VB-685 | VB STD Claim Submission Fact Sheet |
CL-1191 | Vision Claim Form |
MK-1221 | Voluntary benefits claims employer flyer |
CL-1177 | Wellness Benefit Claim Form |