Wilco life insurance company forms 2025

1. Click ‘Get Form’ to open the wilco life insurance company claim form in the editor.
2. Begin with Part 1, where you will enter the Policyowner/Certificate Holder Information. Fill in your name, address, account number, phone number, date of birth, and social security number. Ensure to check the box if your address has changed.
3. In Part 2, complete the Statement of Loss by providing details about the patient including their name, date of birth, relationship to the policyholder, and specifics about the injury such as date and nature of injury.
4. Proceed to Part 3 for the Physician's Statement. This section must be filled out by a physician. They will provide diagnosis details and confirm whether the condition was due to an accidental injury.
5. Finally, in Part 4, have your employer complete their statement regarding your job duties and any time missed from work due to the injury.

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