Get Attn Awd Benefits Dept Po Box 268898 Request For - Maumelle

This guide provides clear and supportive instructions for completing the ATTN AWD BENEFITS DEPT PO Box 268898 Request For - Maumelle form online. Follow these steps to ensure a successful submission for your benefits.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Complete the statement of insured section by providing your full name, account number, date of birth, and Social Security number. Ensure that you print the information clearly.
3. Enter your current address, including street, city, state, and zip code. If your address has changed, check the appropriate box.
4. If the claim is for a dependent, fill in the dependent's name, relationship to you, and their date of birth.
5. Select the benefit types that you are requesting by marking the appropriate checkboxes (Cancer Diagnostic Benefit, Accident Only Wellness Benefit, Critical Illness Health Screening Benefit).
6. If you would like direct deposit for your benefits, complete the direct deposit authorization section. Remember to attach a voided check with this submission.
7. Before submitting, review all information for accuracy. Attach any required documents such as bills, receipts, or evidence of the tests and confirm they include the name of the test and the date of service.
8. Submit your completed claim form by faxing to the provided number or mailing it to the address listed. Ensure that your account number or Social Security number is included on all documents.

Complete your claim request online for efficient processing of your benefits.