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Filing Claims

If an employee or a covered dependent dies or is seriously injured, the appropriate insurance company should be notified immediately.

For the 2017 plan year, Life & AD&D claims should be submitted to:

Life Insurance Company of North America
Life Claims
P.O. Box 22326
Pittsburgh, PA 15222-0326
1-800-238-2125 (phone)
1-412-402-3506 (fax)

For the 2018 plan year, Life Insurance and Group Universal Life (GUL) Insurance claims should be submitted to:

The Prudential Insurance Company of America
P.O. Box 8517
Philadelphia, PA 19176
1-888-257-0412 (phone)
1-888-227-6764 (fax)

For the 2018 plan year, Accidental Death & Dismemberment claims should be submitted to:

Life Insurance Company of North America
Life Claims
P.O. Box 22326
Pittsburgh, PA 15222-0326
1-800-238-2125 (phone)
1-412-402-3506 (fax)

After receiving notification, the insurer will process the claim for payment of benefits. All claims for benefits must be made by filing a properly completed form. If the claim is for a death benefit, a death certificate must be furnished along with the claim form.

If a participant has concerns about how a claim has been administered or wishes to appeal a claims decision, information on relevant procedures is available in Claims Appeal and Review Procedures Under ERISA section.



Claim Forms