Get Continuing Disability Claim Form - Summit Insurance Services

Filling out the Continuing Disability Claim Form provided by Summit Insurance Services can seem overwhelming at first. However, this guide is designed to assist you through each section of the form, ensuring a smooth and straightforward online submission process.

Follow the steps to successfully complete and submit your claim form online.

1. Press the ‘Get Form’ button to access the Continuing Disability Claim Form and open it in the designated online editor.
2. Begin by entering your policy number in the appropriate field.
3. Fill out the policyholder information, ensuring to include required details such as the last name, first name, date of birth, and home address. Mark the checkbox if there is a permanent address change.
4. Proceed to the patient information section. Provide accurate details, including the patient’s last name, first name, date of birth, and sex. Indicate the relationship of the patient to the policyholder.
5. Complete the continuing disability checklist to determine the nature of the disability. Indicate if it is related to sickness or injury, provide the date of injury if applicable, and fill in how the injury occurred.
6. Answer additional questions regarding the patient’s hospital confinement and submit any required hospital documentation if necessitated by the condition.
7. Sign and date the form in the designated signature area as a policyholder or family member, ensuring all information provided is truthful.
8. Once you have completed all sections, review the form for accuracy. Then, save your changes, and you can download, print, or share the completed form as needed.

Take the first step towards your benefits by completing your Continuing Disability Claim Form online today.