Manulife-Disability-Claim-Member-Statement 2026

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  1. Click ‘Get Form’ to open the Manulife-Disability-Claim-Member-Statement in the editor.
  2. Begin by completing the 'Patient Authorization' section on page 2. Ensure that the patient’s name, division number, and plan member certificate number are clearly filled out. The patient must sign and date this section.
  3. Move to the 'Attending Physician's Statement' section. Fill in the primary diagnosis and any additional diagnoses or complications. If applicable, provide the GAF score for psychiatric disorders or functional classification for cardiac disorders.
  4. In the 'Clinical Information' section, document key dates such as when symptoms first appeared and when treatment began. Specify if the condition is due to an injury or illness and detail visit frequencies.
  5. Complete sections regarding treatment details, including names of other practitioners, current medications, and any hospitalizations. Be sure to note responses to treatments.
  6. Finally, review all sections for completeness before submitting. You can either send it directly to Manulife or provide it to your patient.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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If you wish to file for benefits, contact us immediately at 1-800-772-1213 (TTY 1-800-325-0778) to request an appointment. If you delay, some potential benefits could be lost. To speed up the application process, complete an Adult Disability Report and have it available at the time of your appointment.
To access your online statement, follow the steps below. Sign in to the secure site. Click the View My Statements link on the homepage or go to More account options My Account menu. Under Statements, click View My Statements.
Manulife typically pays between 60% to 80% of your pre-disability gross income. The exact amount depends on: Your policy terms (group or individual) Any applicable monthly benefit cap.
Your account statements are available online. To access your online statement, follow the steps below. Sign in to the secure site. Click the View My Statements link on the homepage or go to More account options My Account menu.
The information on the Plan Sponsors Statement is for the assessment of the plan members absence from work under: The Short-Term Disability (STD) plan and where applicable, The Long-Term Disability (LTD) plan. This statement forms part of the plan members disability claims file.

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1-800-268-6195 (8 a.m. to 8 p.m. ET, Mon. to Fri.) General questions about group coverage, claims and more.
0:04 1:14 And select benefits card from the main navigation. From there you can choose to add to Apple Wallet.MoreAnd select benefits card from the main navigation. From there you can choose to add to Apple Wallet. Or save it to your phone by taking a screenshot.

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