Common Contracts
1 similar Disability Claim contracts
ContractDisability Claim • April 26th, 2018
Disability Claim FAX this direction FAX this form: 1-800-880-9325Or mail: P.O. Box 100195, Columbia, SC 29202 From: Number of pages: 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 Plan Administrator Spouse, family member or significant other Name: I want Colonial Life to update me on the status of my claim through electronic messaging at my contact number indicated on this form.I understand that messages will be left with anyone who answers the phone or on my answering machine. Note: To avoid blocked calls, you should program the number 1-800-325-4368 into your phone. Yes,
