Long Term Disability (LTD) & Life Waiver: (800) 254-0085 or [email protected] LTD and Life Waiver claims address: LifeMap Claims 300 Southborough Drive, Suite 200 South …

If you have more than on LifeMap insurance policy, we will apply this authorization to all policies. I AUTHORIZE LifeMap Assurance Company (LifeMap) to disclose the following of information: …

Assignment of Life Insurance Proceeds I, _____________________, being entitled to receive benefits under Policy Number _____________ issued by LifeMap Beneficiary Name …

Claim Filing Instructions This Statement of Accident includes the forms required to apply for Voluntary Accident benefits. Please read this instructions carefully before submitting to LifeMap.

Dependent Eligibility Requirement Dependents must be a Legal spouse and/or child(ren) up to age 26 of the covered employee to be eligible for coverage. LifeMap Network

LifeMap Life 10 Basic Life and AD&D Insurance How the Plan Works is full of twists and turns. LifeMap Basic Life and AD&D coverage protects your family’s future, no matter

• I understand that LifeMap will release information to my employer necessary for return to work and accommodation discussions, and when performing administration for my employer’s self …

This means legal expenses for the beneficiary and delay in the payment of the insurance. Please take this into consideration when naming your beneficiary. If you have any questions, please …

LifeMap ofers FMLA, ADA and other types of leave administration as a buy-up option through FMLASource. Sign up and you’ll enjoy: • Lower administrative costs and improved eficiency • …

LifeMap is not liable for any errors or omissions in this document. If there is any discrepancy between this document and the master policy, master policy provisions will prevail.