Disability claim forms
This service is offered by Assurant Employee Benefits to employers who wish to file a disability claim.
The information requested is required for us to begin reviewing your employee's claim. It's important that the information be complete and accurate information to avoid delays.
Submit a disability claim
1. Choose the form you need:
2. Mail, fax or email the completed and signed form, along with any requested documentation, to:
Employers in the state of New York
Employers in all others states
Union Security Life Insurance Company of New York
PO Box 972208
El Paso, TX 79997-2208
Assurant Employee Benefits
PO Box 972030
El Paso, TX 79997-2030
3. Have a question about filing your claim?
Call 800.451.4531 and select option 1, between 8 a.m. and 5 p.m. Central Time. If you call outside this time frame, please leave a voicemail message and a representative will respond the next business day.