Proof of Loss Claim Statement - Loyola University Chicago 2025

1. Click ‘Get Form’ to open the Proof of Loss Claim Statement in the editor.
2. Begin with Part I, where the employer must complete and sign all required fields, including the insured's name, date of birth, and job title. Ensure to attach a job description and proof of earnings.
3. In Part II, the insured should fill out their personal information, including home address and gender. Answer questions regarding the claim's basis, such as whether it is work-related or due to an accident.
4. Complete the AUTHORIZATION FOR USE IN OBTAINING INFORMATION form by providing necessary details about medical care and treatment. This step is crucial for processing your claim efficiently.
5. Finally, ensure that all sections are filled accurately before submitting. You can easily save and share your completed form directly from our platform for free.

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