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REQUEST FOR INDIVIDUAL CANCER DIAGNOSTIC BENEFITS INSTRUCTION TO INSURED 1. Complete STATEMENT OF INSURED 2. Please attach bill, receipt or evidence of diagnostic screening or preventative testing. Submitted evidence must include the name of the patient, type of test, provider, provider phone number and the date of service. 3. Be sure to include your account number or Social Security number on all documents. 4. Fax or mail completed form and attachments. STATEMENT OF INSURED 1) Patient s Na.

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As American Fidelity has grown, so have the entities owned by the Cameron family. The Cameron Group now encompasses multiple companies providing health, HR and financial security products and services ranging from banking to consultative HR services to property and casualty insurance.

American Fidelity is more than an insurance company. We also offer benefits strategies to help empower you to make benefits decisions that help both your organization and your employees. Our goal is to act as an extension of your human resources department.

Each year since 1982, American Fidelity has met these standards to receive an A+ rating. “Having a creditable third party review our financial information and rate our ability to meet our financial obligations to our Customers helps give them peace of mind,” said Chief Financial Officer John Cassil.

Know we have your back no matter what Fidelity Investments Life Insurance Company is an A+ rated life insurer4 that has supported families like yours since 1987.

About American Fidelity The Company is also recognized as one of Ward's© 50 top performing life-health insurance companies and Foundry's Computerworld 2024 Best Places to Work in IT.

American Fidelity Assurance Company Rating (Rating Category): Affiliation Code:A+ (Superior) g (Group) Outlook (or Implication): Stable Action: Affirmed Effective Date: May 23, 2024 Initial Rating Date: June 30, 1976

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© Copyright 1997-2025
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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