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Disability Benefits Claim - trustmarksolutions.com 2026
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- Click ‘Get Form’ to open the Disability Benefits Claim in the editor.
- Begin with Section A, where you will enter the Insured’s Information. Fill in your Policy/Certificate number, name, date of birth, social security number, address, phone number, email address, gender, height, and weight.
- Move to Section B for Claim Information. Indicate if your disability is due to an accident/injury or sickness. Provide details about when your disability began and describe how it occurred.
- In Section C, complete the tax withholding information. Specify how premiums are paid and ensure that all percentages total 100%.
- Proceed to Section D regarding policy premiums. Choose whether you want premiums withheld from your benefits.
- Finally, review Sections E and any additional statements carefully before signing and submitting the form.
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Related links
Oct 15, 2025 To submit a long-term disability claim or if you have questions regarding this benefit, contact the HR Service Center at 313-577-3000.Read more
Mar 1, 2025 sick pay or other salary continuation, workers compensation benefits, Social Security benefits, disability benefits from any other groupRead more