Common Contracts
3 similar Disability Claim contracts
Disability ClaimDisability Claim • April 27th, 2021
File Your Claim Online Simply log into your account at Coloniallife.com and click on “File an Online Claim”. As an added convenience, you may also select Direct Deposit when filing online.Not a member? Log onto Coloniallife.com and click on “Register” then “Join the Policyholder Website” to set up your account. Optional Service Release Agreement Please indicate below for optional services you desire. Any marks used (check mark, X, initials, etc.) will be considered as your authorization and will be processed as if they were selected.I authorize Colonial Life to facilitate processing this claim by releasing its details to the following individual inquiring on my behalf.Note: Leave blank if you do not want anyone accessing your claim information. Sales representative Employer Spouse, family member or significant other Name: I want Colonial Life to update me on the status of my claim through prerecorded messages at my contact number indicated on this form. I understand that messages will
Disability ClaimDisability Claim • April 20th, 2021
File Your Claim Online Simply log into your account at Coloniallife.com and click on “File an Online Claim”. As an added convenience, you may also select Direct Deposit when filing online.Not a member? Log onto Coloniallife.com and click on “Register” then “Join the Policyholder Website” to set up your account. Optional Service Release Agreement Please indicate below for optional services you desire. Any marks used (check mark, X, initials, etc.) will be considered as your authorization and will be processed as if they were selected.I authorize Colonial Life to facilitate processing this claim by releasing its details to the following individual inquiring on my behalf.Note: Leave blank if you do not want anyone accessing your claim information. Sales representative Employer Spouse, family member or significant other Name: I want Colonial Life to update me on the status of my claim through prerecorded messages at my contact number indicated on this form. I understand that messages will
Disability ClaimDisability Claim • December 20th, 2019
File Your Claim Online Simply log into your account at Coloniallife.com and click on “File an Online Claim”. As an added convenience, you may also select Direct Deposit when filing online.Not a member? Log onto Coloniallife.com and click on “Register” then “Join the Policyholder Website” to set up your account. Optional Service Release Agreement Please indicate below for optional services you desire. Any marks used (check mark, X, initials, etc.) will be considered as your authorization and will be processed as if they were selected.I authorize Colonial Life to facilitate processing this claim by releasing its details to the following individual inquiring on my behalf.Note: Leave blank if you do not want anyone accessing your claim information. Sales representative Employer Spouse, family member or significant other Name: I want Colonial Life to update me on the status of my claim through prerecorded messages at my contact number indicated on this form. I understand that messages will
