LI Notice of Claim-TPD WOP Preview on Page 1

LI Notice of Claim-TPD WOP 2026

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  1. Click ‘Get Form’ to open the LI Notice of Claim-TPD WOP in the editor.
  2. Begin by entering your Participant’s Local Union Number and Date at the top of the form. This information is crucial for identification.
  3. Fill in your full name, address, date of birth, ID number, phone number, occupation, and employer's details in the designated fields.
  4. Indicate whether you were on Medicare by selecting 'Yes' or 'No'. If applicable, attach a copy of your Medicare card.
  5. Select the type of claim you are filing by checking the appropriate box. Ensure all relevant sections are completed based on your situation.
  6. For claims related to death or disability, attach any required documents as specified in the instructions. This may include certified death certificates or medical statements.
  7. Review all entered information for accuracy before signing and submitting the form to TeamCare’s Life Insurance Department.

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