What you need to know to file a claim

If you have insurance—such as disability, critical illness, and accident insurance—you probably hope you don’t ever have to use it. But if you do have to make a claim, it’s a good idea to know the types of information you may need when you contact the insurance company.

Here’s how you can be prepared to submit a claim:

Confirm your eligibility

You will want to confirm your eligibility with your employer or insurance provider before submitting a claim. Depending on the type of insurance coverage you have and your plan details, you will want to ensure that your condition is covered and that you qualify to receive benefits.

Gather personal and medical information

To help the insurance company make an informed decision about your claim, it may request:

From you

  • information about your doctor, your income, and your condition, which may include:
    • ­your identification information, including policy number
    • your diagnosis or injuries
    • type of treatment or care
    • doctor’s contact information
  • authorization for the release and disclosure of information about you that may be needed to evaluate your claim

From your employer

  • information on your claim, your eligibility, and your benefits

From your doctor

  • specific medical information about your condition, care, and expected recovery
  • medical and treatment notes related to your condition

Submit completed paperwork

The insurance company can’t start to evaluate your claim until it has all required information, so it’s important to make sure all the required forms are completed and signed by the appropriate individuals, as missing information or signatures can delay a decision on your claim. Once you have collected all the required information, send your completed forms to your insurance provider so that your claim can be assessed. Once the insurance company receives your paperwork, it will begin its review and will reach out to you if it needs additional information in order to make a claims decision.

Once your insurance provider has made a claims decision, the company will notify you. If you have specific questions about the claims process, what information is required, or your insurance coverage in general, you should refer to your employer—if your coverage is through work—or insurance provider.

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SLPC 26772 09/15 (exp. 09/17)

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