Get Trustmark Accident Claim Form - The Mpm Group

Filling out the Trustmark Accident Claim Form - The MPM Group is an important step in securing your benefits. This guide provides a detailed explanation of each section to assist you in completing the form accurately and efficiently.

Follow the steps to successfully complete the form

1. Click ‘Get Form’ button to access the Trustmark Accident Claim Form online.
2. Begin with Section A, where you will fill out information as the policy owner. This includes providing your policy or certificate number, your full name, your date of birth, and your address. Make sure to include a phone number for both home and work.
3. In Section B, you must provide a detailed account of your accident. This includes the date of the accident, the date of your first treatment, and a description of the incident. Attach itemized copies of any bills related to your treatment.
4. Section C requires information from your attending physician. This section includes medical details such as diagnoses, hospital information, and work-related accident status. Ensure the physician completes this section thoroughly.
5. Section D is focused on your employer if you are claiming the Accident Disability Benefit. Your employer will need to confirm your job duties, the duration of your inability to work, and other relevant employment details.
6. Once all sections are completed, ensure that all signatures are signed and dated accordingly. This includes the policy owner's signature and any relevant signatures from the attending physician or employer.
7. Before submitting, review the entire form to ensure all fields are filled accurately to prevent processing delays. Save the form, and you can also download or print a copy for your records.
8. Finally, submit the completed form and any additional required documentation as instructed. Keep a copy for your personal records.

Complete your Trustmark Accident Claim Form online today to ensure your claim is processed quickly and efficiently.