How to File a Claim

Life — When and how to file a Life Insurance Claim

In the event of an employee passing away, the Life Claim Form should be completed by the employee's family member or the executor and the employer.  An official death certificate and the complete beneficiary information should be sent with the form. The completed form and original death certificate should be sent via mail to 4A's Benefits. We will review the form to check for any missing information and forward all the information to the dedicated insurance adjuster.

AD&D — When and how to file an AD&D insurance claim

In the event of an injury that results in dismemberment, the AD&D form should be completed by the employee and the employer.  Copies of the medical records documenting the event along with the completed form should be sent via mail to 4A's Benefits. We will review the form to check for any missing information and forward all the information to the dedicated insurance adjuster.

In the event of an accidental death, both the AD&D and the Life Claim Form should be completed by the employee's family member or the executor and the employer. Copies of the police report, medical examiner report, and the original death certificate should be sent along with the completed form via mail to 4A's Benefits. We will review the forms to check for any missing information and forward all the information to the dedicated insurance adjuster.

STD — When and how to file an STD Claim

An STD claim form should be completed if you are expected to be out more than 7 days from work, due to a medical disability. Please choose the correct STD form based on your employer's current coverage plan.   The form should be completed by the employee, employer and the attending physician. The completed form should be sent via fax or email to 4A Benefits. We will review the form to check for any missing information and forward all the information to the dedicated insurance adjuster. There is a waiting period from the date of disability to the date before benefits would begin; this time period is based on your employer's plan. If the claim is submitted more than 30 days after the first date of disability, the claim may be denied.

LTD — When and how to file an LTD Claim

If you are out of work due to a disability, please complete the LTD claim form no later than the 45th day from the first day of the disability.   The form should be completed by the employee, employer and the attending physician. The completed form should be sent via fax or email to 4A's Benefits. We will review the form to check for any missing information and forward all the information to the dedicated insurance adjuster. The insurance carrier might require you or the physician to furnish additional documentation before making a disability decision. There is a waiting period, based on your coverage, from the first date of the disability to the date when benefits would begin.