4031 Fax-2026

See details

4.8 out of 5

132 votes

The document provides detailed instructions and forms for applying for Specified Disease Benefits from The Standard Life Insurance Company of New York. It outlines the necessary steps to complete the claim application, including filling out the Employee's Statement, obtaining an Authorization to Obtain and Release Information, and having an Attending Physician complete their statement. The document emphasizes the importance of providing complete information to avoid delays in processing claims.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out 4031 Fax with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the 4031 Fax in the editor.
Begin by filling out the 'About the Insured' section. Enter your full name, employer, group policy number, social security number, phone number, sex, date of birth, and mailing address.
In the 'About the Patient' section, indicate whether the patient is you or another individual. Provide their full name, social security number, phone number, date of birth, and sex.
Complete the 'About the Specified Disease' section by checking all applicable conditions. Ensure you provide a diagnosis date and indicate if this is a previously filed claim.
Fill in details about your physician(s) in the 'About the Physician(s) and Hospital(s)' section. Include names, addresses, specialties, and contact information for each provider.
Finally, review all entries for accuracy. Sign and date where required before submitting your completed form.

Start using our platform today to fill out your 4031 Fax easily and for free!

See more 4031 Fax versions

We've got more versions of the 4031 Fax form. Select the right 4031 Fax version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (132 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

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.

How to find work fax number?

Steps Check the business website to see if their fax number is listed. Go to the company website you want to fax and look for the Contact Us section. Search for the fax number online. Use a search engine of your choice and type in the business name. Contact the business and ask them directly.

How to send a fax with Humblefax?

Send an email to @humblefax.com and fill out the email subject and body - this becomes your cover sheet. Attach your documents, such as pdf or doc, and send. You will receive a confirmation email to let you know that the fax was sent successfully.

How to find a companys fax number?

Use your fax machine to call a phone with caller ID. The number displayed after the phone connects is your fax number. For example, if you dont know the number of your work fax machine, call your personal cell phone with the machine.

How to identify a fax number?

With normal faxing, the number that a fax was sent from is included in the footer. If the fax has been sent within the United States, the first three digits are the area code, followed by the fax number. You should be able to locate a ten or eleven-digit number on each page.

How to find your jobs fax number?

A fax number is simply a phone number assigned to a fax machine instead of a phone. In many instances, you can use the same line for faxes and phone calls. The main reason for having separate lines is that you cant use one line for both faxes and phone calls at the same time.