myuhc.com
myuhc.com UnitedHealthCare
  
 
Group Disability, Life and Supplemental Health Information


If you live in New York or California:

New York: If you are a resident of the State of New York or covered under a Policy issued by Unimerica Life Insurance Company of New York and wish to submit a claim, please contact your employer. For general questions about the claim process, you may also contact Unimerica Life Insurance Company of New York at 1-888-299-2070.

California: If you are a resident of the State of California and wish to submit a claim, please contact your employer.
 


________________________________________________________________________

  How to file a claim
  1. Choose the appropriate claim packet below.
  2. Complete, sign and date the necessary forms in the packet.
  3. Use the contact information on the form to fax or email your claim.
       - E-mail: fpcustomersupport@uhc.com
       - Fax: 1-888-505-8550
       - Phone: If you have any questions, please call our claims department at
        1-888-299-2070, between 8 a.m. and 6 p.m. ET.

________________________________________________________________________

Claim Form Packets

(Note: Not for members living in New York or California.)

 Disability Insurance
 Short-Term Disability Claim Form Packet
 Long-Term Disability Claim Form Packet


  Life Insurance 
  Life Claim Form Packet (Standard)
  Life Claim Form Packet (for residents of KS, AR, CO, MD, NC, ND, or NV)


  Hospital Indemnity Protection Plan
  
Hospital Indemnity Protection Plan Claim Form Packet


  Critical Illness Protection Plan
  
Critical Illness Protection Plan Claim Form Packet (Standard)
  Critical Illness Protection Plan Claim Form Packet (Enhanced) Note: Use if your
  plan includes Child Critical Illness, Additional Critical Illness, or Partial Benefit
  Critical Illness benefit options. If you are not sure if your plan includes these
  benefits, please refer to your Certificate of Coverage or contact your employer
.


  Accident Protection Plan
  
Accident Protection Plan Claim Form Packet


________________________________________________________________________


  Standalone Authorization
  Standalone Authorization Form
 


________________________________________________________________________

Note about email: We cannot guarantee the security of any communication transmitted through the internet. We are not liable for the illegal acts of third parties such as criminal hackers. Please use your best judgment when deciding how to email your information. We can accept emails sent with or without encryption.
 

UnitedHealthcare Life and Disability products are provided by UnitedHealthcare Insurance Company and certain products in California by Unimerica Life Insurance Company. Life and Disability products are provided on policy forms LASD-POL (05/03) et al. and UHCLD-POL 2/2008 et al., in Texas on forms LASD-POL-TX(05/03) and UHCLD-POL 2/2008-TX and in Virginia on LASD-POL(05/03) and UHCLD-POL 2/2008.  The policies have exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued.  For costs and complete details of the coverage, call or write your insurance agent or the company.  Some products are not available in all states.  UnitedHealthcare Insurance Company is located in Hartford, CT and Unimerica Life Insurance Company is located in Milwaukee, WI.

UnitedHealthcare Critical Illness product is provided by UnitedHealthcare Insurance Company on form UHICI-POL-1 et al., in Texas on UHICI-POL-1 and in Virginia on UHICI-POL-1-VA.  Critical Illness coverage is NOT considered "minimum essential coverage" under the Affordable Care Act and therefore does NOT satisfy the mandate to have health insurance coverage. Failure to have other health insurance coverage may be subject to a tax penalty. Please consult a tax advisor.  The policies have exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued.  For costs and complete details of the coverage, call or write your insurance agent or the company.  Some products are not available in all states.  UnitedHealthcare Insurance Company is located in Hartford, CT.

UnitedHealthcare Accident Protection product is provided by UnitedHealthcare Insurance Company on form UHCAC-POL-1 (01/12) et al., in Texas on form UHCAC-POL-1-TX (01/12) and in Virginia on UHCAC-POL-1-VA (01/12).  The policies have exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued.  For costs and complete details of the coverage, call or write your insurance agent or the company.  Some products are not available in all states.  UnitedHealthcare Insurance Company is located in Hartford, CT.

UnitedHealthcare Hospital Indemnity product is provided by UnitedHealthcare Insurance Company on policy forms UHIHIP-POL-TX, et al. and UHIHIP-CERT-TX, et al. in Texas and UHIHIP-POL-VA, et al. and UHIHIP-CERT-VA, et al. in Virginia. The product provides a limited benefit for certain hospital indemnity plan benefits.  Please note: HOSPITAL INDEMNITY coverage is NOT considered "minimum essential coverage" under the Affordable Care Act and therefore does NOT satisfy the mandate to have health insurance coverage. Failure to have other health insurance coverage may be subject to a tax penalty. Please consult a tax advisor.  The policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued.  For costs and complete details of the coverage, call or write your insurance agent or the company.  This product is not available in all states. UnitedHealthcare Insurance Company is located in Hartford, CT.

Life and Disability products are provided by Unimerica Life Insurance Company of New York. Life and Disability products are provided on policy forms LASD-POL-LIFE NY (05/03) and LASD-POL-ADD/DIS NY (05/03). This policy includes exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company. Unimerica Life Insurance Company of New York is located in New York, NY.

Specified Disease insurance is provided by Unimerica Life Insurance Company of New York on form UHICI-POL-1-NY. Specified Disease coverage is NOT considered "minimum essential coverage" under the Affordable Care Act and therefore does NOT satisfy the mandate to have health insurance coverage. Failure to have other health insurance coverage may be subject to a tax penalty. Please consult a tax advisor. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company. Unimerica Life Insurance Company of New York is located in New York, NY.

Accident Protection product is provided by Unimerica Life Insurance Company of New York on form UHCAC-POL-1-NY (01/12). This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company. Unimerica Life Insurance Company of New York is located in New York, NY.

Hospital Indemnity Protection Plan is provided by Unimerica Life Insurance Company of New York on policy form UHIHIP-POL-NY. The product provides a limited benefit for certain hospital indemnity plan benefits.  Please note: HOSPITAL INDEMNITY coverage is NOT considered "minimum essential coverage" under the Affordable Care Act and therefore does NOT satisfy the mandate to have health insurance coverage. Failure to have other health insurance coverage may be subject to a tax penalty. Please consult a tax advisor.  The policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued.  For costs and complete details of the coverage, call or write your insurance agent or the company.  Unimerica Life Insurance Company of New York is located in New York, NY.