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PAGE 1 POLICY APPLICATION for NEW YORK STATUTORY DISABILITY BENEFITS DBL HARTFORD LIFE INSURANCE COMPANY Please issue a policy insuring the EMPLOYER S compliance with Article 9 of the Workers Compensation Law as follows PLEASE PRINT OR TYPE LEGIBLY 1.

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Explore your options to find the right coverage. General Liability Insurance. Car Liability Insurance. Home Liability Insurance. Personal Liability Insurance. Workers' Comp Insurance. Liability Insurance for Small Business. Professional Liability Insurance. Umbrella Liability Insurance.

Our Living Benefit Option that accelerates the benefits of terminally ill employees or dependents up to $500,000. Our No Interruption in Premium Waiver Elimination Period for employees who attempt to return to work for up to five days. Our Portability Option and Conversion is offered with our Life insurance product.

There are two types of disability policies. Short-term policies may pay for up to two years. Most last for a few months to a year. Long-term policies may pay benefits for a few years or until the disability ends.

How long do I have to wait before I can receive my benefit? Once your claim is approved, you will be eligible to collect your Short Term Disability benefit starting on the 8th day after your disability occurs. Your benefit could continue for up to 25 weeks.

Supplemental insurance provides an additional opportunity for employees to have coverage for out-of-pocket expenses or unexpected costs that may not be covered by their main health plan, such as: Deductibles and co-pays. Treatment-related transportation, lodging and/or meals. Experimental treatments.

Our Term Life insurance offers more than just death benefits. The following options are also available: Living Benefit Option (Accelerated Death Benefit) Accidental Death & Dismemberment (AD&D) Rider.

Long-Term Disability Insurance (LTD). Long-term disability insurance has an elimination period of at least 90 days. After that, benefits are paid for a longer term, typically, two years, five years, 10 years, to age 65, or for life, depending on the policy.

Long-Term Disability Insurance (LTD). Long-term disability insurance has an elimination period of at least 90 days. After that, benefits are paid for a longer term, typically, two years, five years, 10 years, to age 65, or for life, depending on the policy.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232