How to file a Claim

• Accident Insurance
• Critical Illness Insurance
• Hospital Recovery Insurance
• Long Term Care Insurance

We encourage you and your family to contact us anytime – not just at time of claim – with any questions or concerns you might have. 

Accident

You or your representative can obtain a claim form by calling: 888.575.8246 or writing to:

You may also click here for immediate access to a fillable PDF of the claim form.

Simply have the claim form completed as instructed* and return it back to LifeSecure with the following:

• Copies of all bills relating to the claim, such as hospital, emergency room, ambulance and physician office visit bills. All bills must include the diagnosis, and must show a complete itemization of all services rendered and the individual charge for each service. Bills that show only a summary of services and charges cannot be accepted.
• For each bill, we require a copy of the corresponding Explanation of Benefits (EOB) from your primary health insurance.

* With regard to Section E (Attending Physician’s Statement for Accidental Injury) of the claim form, if the claimant was initially treated in a hospital emergency room, you may instead submit a copy of the emergency room physician’s report which can be obtained from the treating hospital. If initially treated in a physician’s office or urgent care center, you may submit the physician’s office or urgent care center records and notes pertaining to the visit.

Mail your claim to the above address, or fax to 877.226.7315, or send electronically by clicking "Your Policy" in the top menu bar. Your claim form, bills and EOBs must be submitted to us within 120 days from the date of loss (Note: timeframes my vary by state). You do not need to wait until all bills and EOBs are received to begin sending your claim.

Upon receipt and confirmation of the Claimant’s benefit eligibility, LifeSecure will calculate the payable benefit. This benefit will be payable to the Policyholder/Certificateholder, via a check by mail, or through electronic funds transfer to their checking or savings account – whichever method was elected by the Policyholder/Certificateholder on the claim form.

Policyholders/Certificateholders should refer to their actual insurance policy/certificate for more complete language regarding benefit eligibility and the overall claims process.

Critical Illness

You or your representative must complete a claim form, which can be requested by calling 888.575.8246 or writing to:

You may also click here for immediate access to a fillable PDF of the claim form.

Simply have the claim form fully completed and return it to us along with written Proof of Diagnosis. Proof of Diagnosis includes documentation of:

• Date the Specified Disease began,
• Cause of the Specified Disease,
• Prognosis of the Specified Disease, and
• Names and addresses of all attending physicians.

Mail your claim to the above address, fax to 877.226.7315, or send electronically using your Personal Web Portal at www.YourLifeSecure.com (select "Policyholders" from the login menu).

Upon receipt and confirmation of your benefit eligibility, LifeSecure will calculate your Benefit Payout Amount. This benefit will be payable directly to you, via a check my mail, or through electronic funds transfer to your checking or savings account — whichever method is elected by you on your claim form. 

If your Critical Illness insurance policy includes the Health Screening Benefit, see below.

The LifeSecure Health Screening Benefit will pay $50 once per calendar year to each Covered Personal for one of the wellness procedure listed below. The procedure must occur after a one-time 30 day Benefit Wait Period. Use the contact information at the top of this page to obtain a Wellness Screening Form to submit this claim or click here for immediate access to a fillable PDF.

Covered Procedures:

Policyholders should refer to their actual insurance policy for more complete language regarding benefit eligibility and the overall claims process.

Hospital Recovery

You or your representative can obtain a claim form by calling: 888.575.8246 or writing to:

You may also click here for immediate access to a fillable PDF of the claim form.

Simply have the claim form completed as instructed and return it back to LifeSecure with the following:

A copy of the UB-04 Uniform Billing Form, which can be provided to you by the servicing hospital. If the hospital will not provide you with a UB-04 Form, we will accept an itemization of services. The itemization of services must include diagnosis(es), name of hospital, the hospital’s Tax Identification Number (TIN), and whether the stay is being billed as inpatient or observation, if covered by the policy.

Mail your claim to the above address, fax to 877.226.7315, or send electronically by clicking "Your Policy" in the top menu bar. You do not need to wait until you have received the UB-04 form to begin sending your claim. 

Upon receipt and confirmation of the Claimant’s benefit eligibility, LifeSecure will calculate the payable benefit. This benefit will be payable to the Policyholder/Certificateholder, via a check by mail, or through electronic funds transfer to their checking or savings account – whichever method was elected by the Policyholder/Certificateholder on the claim form.

Policyholders/Certificateholders should refer to their actual insurance policy/certificate for more complete language regarding benefit eligibility and the overall claims process.

Long Term Care

You or your representative must notify us of your claim request by calling: 888.575.8246 or writing to:

We can collect the information we need to determine your eligibility for benefits. We may need to contact your physician and review your medical records. We may also arrange for an assessment to be performed by a nurse. A LifeSecure Care Advisor will notify you once we have determined your eligibility for benefits.

We can arrange for a Plan of Care to be developed by a Licensed Health Care Practitioner.

Once your Benefit Wait Period has been met, benefit payments will be made upon receipt of proof of loss to you or a care provider to whom you assign benefits. All benefits payable are pursuant to your written Plan of Care.

Policyholders should refer to their actual insurance policy for more complete language regarding benefit eligibility and the overall claims process.

LS-0407 ST 08/21 PE