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Colonial life wellness claim form

Colonial life wellness claim 2025

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4.8 out of 5

181 votes

The document provides instructions for filing a health/wellness screening claim with Colonial Life, including options for faxing or mailing the claim form, online submission, and necessary authorizations. It outlines the required information for claimants, details on optional service release agreements, and includes fraud warning statements mandated by various states. Additionally, it specifies the types of screening tests covered and emphasizes the importance of completing the form accurately to avoid delays in processing.

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Click ‘Get Form’ to open the Colonial Life Wellness Claim in the editor.
Begin by filling out the Claimant Statement section. Enter your name, date of birth, and Social Security number. Indicate your relationship to the policy owner.
Complete the Policy Owner Information section if it differs from the claimant. Provide their name, date of birth, address, email, and contact number.
In the Screening Test section, list each test performed along with its date in MM/DD/YYYY format. Ensure you attach copies of relevant bills.
Review the Certification section carefully. Sign and date it to confirm that all information is accurate and complete.
Finally, submit your completed form via fax or mail as indicated on the document.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (181 Votes)
2019	4.4 Satisfied (119 Votes)
2018	4.3 Satisfied (127 Votes)
2017	4.3 Satisfied (61 Votes)
2013	4.3 Satisfied (41 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a wellness claim?

With Colonial Life, you can submit your claim online, fax the completed paperwork, or mail in the completed form. The form has three sections: a claimant statement, your employers statement, and your attending physicians statement.

What is an example of a wellness claim?

Some examples of wellness claims from non-traditional healthcare providers are: Receipt for a flu shot received at a drug store. Invoice for a smoking cessation program. Invoice from a weight-loss program.

What is considered a wellness claim with AFLAC?

Aflac wellness claims pay you cash benefits* for staying on top of your health by getting yearly checkups and medical screenings such as physicals, dental exams and eye exams. Most accident, hospital indemnity and cancer insurance policies have wellness benefits.

What is Colonial Lifes claims process like?

If youre disabled with a covered mental or nervous condition, disability insurance from Colonial Life Accident Insurance Company offers a monthly benefit that can help provide financial support while you focus on recovery.

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