Claim Forms
- Accident Claim Fax Cover Sheet
- Critical Illness Claim Form
- Disability Claim Form
- Medical Illness Claim Form
- Medical Accident Claim Form (In English) / (en Español)
- Premium Waiver Form
- Prescription Drug Claim Form
- Wellness Claim Form
Home Health Care (HHC) Forms
- HHC Standard Benefits Claim Form by ManhattanLife
- HHC Standard Benefits Claim Form by Standard Life
- HHC Extra Benefits Claim Form by ManhattanLife
- HHC Extra Benefits Claim Form by Standard Life
- HHC Critical Accident Claim Form by ManhattanLife
- HHC Critical Accident Claim Form by Standard Life
Short Term Care (STC) Forms
Other Forms
- Affidavit of Lost Policy Form
- Bank Draft Authorization Form (In English) / (en Español)
- Beneficiary Change Form
- Health Policy Cancellation Form
- HIPAA Form (release PHI from provider) / Other HIPAA Form (release PHI to agent, family member, other 3rd party)
- Persistency Bonus/Return of Premium Surrender
- Policy Service Form
