Common Contracts
1 similar null contracts
Disability ClaimNovember 6th, 2013
Optional Service Release Agreement Please indicate below for optional services you desire. Any marks used (check mark, X, initials, etc.) will be considered as your authorization and will be processed as if they were selected.I authorize Colonial Life to facilitate processing this claim by releasing its details to the following individual inquiring on my behalf.Note: Leave blank if you do not want anyone accessing your claim information. Sales representative Employer Spouse, family member or significant other Name: I want Colonial Life to update me on the status of my claim through electronic messaging at my contact number indicated on this form.I understand that messages will be left with anyone who answers the phone or on my answering machine. Note: To avoid blocked calls, you should program the number 1-800-325-4368 into your phone. Yes, I want ALL payment(s) for this claim sent by overnight delivery. I understand payment(s) under $100.00 cannot be sent overnight.I also understand t
