How to File a Claim?
Claim Forms

LTD Claim Form

Hartford LIfe Insurance company application for Long Term Disability benefits. This needs to be completed by several parties, yourself, your employer, and your doctor. 

Accidental Death Claim and Group Life Claim Form

This form needs to be completed by both the beneficiary and the employer.
This web site is not a legal document.  This web site is not a guarantee of coverage, eligibility, or provider status and is designed for informational illustration only.  Benefits outlined on this web site are subject to change at any time.  Please consult your benefit plan provider(s) or administrator(s) for legal documents regarding your plan and to check coverage and/or eligibility.