Disability benefits claim forms
Have coverage through an advisor? You're in the right place.
If you have coverage through your employer or plan sponsor, use our workplace benefits insurance forms instead.
Start a claim
Use this form to apply for disability benefits.
To make a claim:
Step 1: Complete part 1 of the claim form.
Download this form and print it, or fill it out in Adobe Reader XI or higher - Opens in a new window (not your browser) and save. You'll need to complete part 1.