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Get Cigna Lms-613500 2006-2025
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How to fill out the CIGNA LMS-613500 online
Completing the CIGNA LMS-613500 form online is a straightforward process that ensures timely handling of life insurance or accidental death claims. This guide offers step-by-step instructions to assist you in accurately filling out the necessary fields, thereby expediting your claim.
Follow the steps to successfully complete the form.
- Press the ‘Get Form’ button to access the CIGNA LMS-613500 document. This will open the form in your preferred online editor.
- Fill in the 'Name of Employee/Insured' section by entering the last name, first name, and middle initial of the insured individual.
- Indicate the date of birth, social security number, and sex of the insured. Provide the residential address including the street, city, state, and zip code.
- Select the marital status of the insured from the options provided: single, married, widow/widower, separated, divorced, or domestic partner.
- Enter the policy number(s) related to the insurance and the insured's occupation. If the insurance was based on a physical condition statement, check 'Yes' and attach the necessary documentation.
- Complete the employment status by checking the applicable boxes regarding the insured's job classification and work hours.
- Provide details regarding the insured’s earnings and coverage dates, including the amount of insurance and the percentage of their contribution towards the premium.
- If claiming for dependent benefits, complete the dependent's information including their name, date of birth, social security number, and relationship to the employee.
- In the certification section, the employer or administrator must sign and input their title and contact number to verify the accuracy of the information provided.
- Once all sections are completed, save your changes. You can choose to download, print, or share the form as needed.
Start filling out your CIGNA LMS-613500 form online today to ensure a prompt claim process.
To submit a claim for reimbursement with CIGNA LMS-613500, start by obtaining a claim form from Cigna’s website. Fill out the required details, including your policy information and expenses incurred. Attach all relevant receipts, then submit the form via their online portal or by mail for processing.
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