Assurant Employee Benefits

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Filing a claim

Filing a Claim

 

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Filing a long-term disability or short-term disability claim

If an insured under an Assurant Employee Benefits Long-Term or Short-Term policy becomes disabled, a claim should be submitted using these forms. Both the LTD and STD claim statement forms have detailed instructions to assist you.

Filing a life claim

If a person insured under a Assurant Employee Benefits Group Life insurance policy dies, a claim should be submitted using the Life Claim Statement. For life insurance claims, the following is also required: a certified copy of the Death Certificate, the Employee Application and beneficiary changes (if maintained by the policyholder).

There are some situations where additional information might be required:

If the beneficiary is a minor: submit certified letters of guardianship for the minor's estate.

If the beneficiary is the estate, submit certified letters of testamentary appointing the Executor/Administrator of the estate.

If the claim is incurred within the first three months of coverage, payroll records or other proof of active work will be required.

Filing a life disability claim

If a person insured under an Assurant Employee Benefits Group Life insurance policy becomes disabled (and the policy has a life insurance disability benefit), a claim should be submitted using the Life Disability Claim Statement. This benefit is commonly known as a "waiver of premium" benefit.

Filing a dental claim

The Dental Claim Form should be used to file a claim when dental services are rendered on an insured. The claim form is completed by the dentists and mailed to the Benefit Center on the back of the insured's Assurant Employee Benefits Dental ID card. You can also obtain the correct mailing address by calling us at 800.442.7742.

Filing an insured vision claim

Employees get the most from their vision benefits when they visit a VSP doctor. VSP’s doctor network offers a wide choice of private practice optometrists, ophthalmologists and opticians. A VSP provider can be located by visiting www.vsp.com or by calling VSP’s Member Services department at 800.877.7195.

If you visit an in-network provider for services and materials, you don’t need an ID card or have forms to complete.

If you visit an out-of-network provider for services and materials, you’ll be required to pay the full amount by that provider at that time. You can then submit a claim for reimbursement, which is a lesser benefit when compared to visiting a VSP doctor.

Filing a group dependent life insurance claim

If a dependent person insured under Assurant Employee Benefits Group Life Insurance policy dies, a claim should be submitted using the Dependent's Life Claim Statement. The following is also required: a certified copy of the death certificate and a copy of the Employee Application.

Filing an accidental dismemberment claim

If a person insured under a Assurant Employee Benefits Group Life Insurance policy suffers a dismemberment loss, a claim should be submitted using the Accidental Dismemberment Claim Statement or Accidental Dismemberment Claim Statement - New York. The following is also required: a copy of the Employee Application and copies of medical records pertaining to the accidental injury

 

Filing an accident claim

If a person insured under an Assurant Employee Benefits Group Accident Insurance policy becomes injured, dismembered or dies due to a covered accident, a claim should be submitted using the Accident Claim Statement. Appropriate documentation (e.g. medical bills, hospital bills, operative report) is required pertaining to the accident.

Filing a cancer claim

If a person insured under an Assurant Employee Benefits Group Cancer Insurance policy is diagnosed with and receives services or treatment for a covered cancer, a claim should be submitted using the Cancer Claim Statement. Appropriate documentation (e.g. medical bills, hospital bills, operative report) is required pertaining to the cancer treatment.

 

Filing a critical illness claim

If a person insured under an Assurant Employee Benefits Group Critical Illness Insurance policy is diagnosed with a covered critical illness or undergoes a covered procedure, a claim should be submitted using the Critical Illness Claim Statement. Appropriate documentation (e.g. medical records, operative report) is required pertaining to the critical illness.

 

Filing a hospital confinement indemnity "gap" claim

If a person insured under a Group Hospital Confinement Indemnity (GAP) policy administered by Assurant Employee Benefits receives treatment, services or supplies that are covered under that policy, a claim should be submitted using the Gap Claim Statement or Gap Claim Statement - Spanish. Appropriate documentation (e.g. an Explanation of Benefits from your Major Medical Plan) is required pertaining to the treatment, services or supplies you received. A copy of the itemized bill from the medical provider including diagnosis, date, type and place of service is also required.

 

Filing a wellness screening claim

If a person insured under an Assurant Employee Benefits Group Accident or Critical Illness Insurance policy receives a wellness screening, a claim should be submitted using the Wellness Screening Claim Statement. Complete a separate form for each family member and date of service. No supporting documentation is required to submit the claim.

 

Filing a cancer screening claim

If a person insured under an Assurant Employee Benefits Group Cancer Insurance policy receives a cancer screening, a claim should be submitted using the Cancer Screening Claim Statement. Complete a separate form for each family member and date of service. No supporting documentation is required to submit the claim.