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Get Unum Wellness Claim Form
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How to fill out the Unum Wellness Claim Form online
Completing the Unum Wellness Claim Form online can streamline the claim process for your health screening and wellness benefits. This guide will provide you with clear, step-by-step instructions to ensure that you fill out the form accurately and efficiently.
Follow the steps to effectively fill out the form.
- Press the ‘Get Form’ button to access the Unum Wellness Claim Form and open it in the appropriate editor or viewer.
- Begin by providing your personal information in the Insured section. Fill in your last name, first name, and middle initial. Enter your date of birth, social security number, gender, and home address, including city, state, and zip code. Include your home, cellular, and work telephone numbers, as well as your preferred email address.
- In the Patient section, indicate whether the claim is for yourself, a spouse, domestic partner, or child. Complete the relevant fields for last name, first name, middle initial, date of birth, social security number, gender, and home address.
- In the Health Screening/Wellness Benefit Claim section, check all the tests that were performed on the patient. For each test, provide the date it was performed. This includes various blood tests, imaging tests, and screenings.
- Review the Tax Considerations section to understand the potential tax implications of the benefits received under your policy.
- In the Signature section, read the statements regarding the accuracy of information provided and the acknowledgment of fraud notices. Sign and date the form. If you are signing on behalf of another person, indicate your relationship and attach appropriate authority documentation.
- If you wish to authorize the sharing of information with a third party, complete the Optional Authorization section with the names and relationships of those individuals. Sign and date this section as well.
- Finally, save your changes. You can download, print, or share the completed form to ensure it is submitted to Unum at the designated address or fax number.
Complete your Unum Wellness Claim Form online today for a smoother claims experience.
To fill out a life insurance claim form, begin by gathering essential documents like the policy number, death certificate, and identification. Carefully complete the Unum Wellness Claim Form with accurate information, paying attention to details. If you encounter any difficulties, consider using platforms like uslegalforms, which can provide templates and guidance to simplify the process significantly.
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