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  • Employees & Families Protect what's important with benefits from Unum.
  • Employers & Plan Administrators Offer better benefits for the people who keep your business growing.
  • Brokers & Sales Partners Connect your clients to powerful benefit solutions.
  • About Us We help people when they need it the most.

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Life Insurance

You want to make sure your family is taken care of, but you don't know what the future holds. If you pass away, Unum Life Insurance can help your family cover funeral costs, day-to-day expenses, bills, and other expenditures.

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A Life Insurance policy can protect what matters most

Life Insurance can help your loved ones with financial obligations in the case of your death — from their daily expenses and mortgage to college tuition or retirement.

Unum offers a range of policies for every stage of your life. Whether you’re getting married, planning for a baby, switching careers or preparing for retirement, you can find coverage that perfectly fits your needs.

How Life Insurance works

Term life insurance.

Term Life Insurance provides affordable protection for a specific period of time — though, in some cases, coverage can be extended past the original term period. Most people buy it during their working years, so if they die, their benefit can help protect their loved ones from the financial impact of lost wages and manage their financial needs.

Whole Life Insurance

Whole Life Insurance offers longer-term coverage with the ability to build cash value at a guaranteed rate — and is tax-deferred and accessible during your lifetime. Instead of adjustable premiums and benefits, however, the coverage remains constant as you grow older.

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How Life Insurance compares

Costs, eligibility and waiting periods before benefits are dispersed can vary depending on your plan. Talk with your HR representative for more details.

Commonly asked questions about Life Insurance

Have questions.

Find out more about Term or Whole Life insurance.

This life insurance does not specifically cover funeral goods or services and may not cover the entire cost of your funeral at the time of your death. The beneficiary of this life insurance may use the proceeds for any purpose, unless otherwise directed.

Applicable to policy forms C.FP-1, et al. UA-GTLP21-1, L-21825, L-21848, FUL-21825, and FUL-21848.

The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. See the actual policy or your Unum representative for specific provisions and details of availability.

Group Term Life Insurance is underwritten by Unum Life Insurance Company of America, Portland, ME. In New York, group term life is underwritten by First Unum Life Insurance Company, New York, NY.

Whole Life Insurance is underwritten by Provident Life and Accident Insurance Company, Chattanooga, TN. In New York, whole life insurance is underwritten by First Unum Life Insurance Company, New York, NY.

unum assignment of benefits form

Claim forms

Most vision providers will submit claims on your behalf, but if you need to submit a claim yourself, please use the claim form linked below. Please check with your provider to verify if you need to submit a claim.

Submitting a claim

To submit a claim, download the form linked below, complete it and return it to us along with a detailed receipt from your dentist. You can send it by any of the options below.

  • Email  here
  • Fax to 855-400-9307, or
  • Mail to: Claims Department P.O. Box 80139 Baton Rouge, LA 70898-0193
  • Download form

Other vision forms:

Grievance Form  — Request for review and reconsideration of a submitted claim.

AZ Health Coverage Appeal Information Packet  — Important information for our members in Arizona about how to appeal decisions Starmount Life Insurance Company makes about your health coverage.

Hearing Savings Plan Flyer  — Learn how you can access savings on hearing instruments and accessories.

For additional forms and documents, visit  your member website .

IMAGES

  1. Assignment Of Benefits Form

    unum assignment of benefits form

  2. Medicare Beneficiaries Assignment of Benefits Form

    unum assignment of benefits form

  3. Fillable Online express rhodes Fillable Online UNUM Voluntary Life

    unum assignment of benefits form

  4. UNUM Whole Life Benefits Summary

    unum assignment of benefits form

  5. Assignment Of Benefits

    unum assignment of benefits form

  6. Nys Assignment of Benefits Form

    unum assignment of benefits form

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  5. Learn about Annuities

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COMMENTS

  1. Download forms for Employers and Plan Administrators

    We offer a variety of downloadable forms to make it easy to do business with us. Search our forms library or access our electronic signature and IRS forms today. ... Voluntary Benefits Disability: CL-1064: Download: Claim - IDI Disability: CL-1020: Download: Claim - Disability Status Update Form: ... Unum is a registered trademark and marketing ...

  2. Download forms

    AE-1269. Group Whole Life Conversion Form (for use in all states except CA, KS, MA, MI, MN, NJ, NY, UT, VA, VT, WA) AE-1268-FL. Group Whole Life Enrollment Form for use with ADB for LTC - Florida. AE-1268-IN. Group Whole Life Enrollment Form for use with ADB for LTC - Indiana.

  3. Download forms

    Beneficiary Change Request Voluntary Benefits - New York. CS-1110. Beneficiary Designation Form. AE-1172-NY. Beneficiary Designation Form - Group. AE-1173-NY. Beneficiary Designation Form - Individual. CS-1123. Beneficiary Designation Form - Life Waiver.

  4. Submit Forms Online with Electronic Signature Forms

    Please call Unum at 800-635-5597. Representatives are available from 8 a.m. to 8 p.m. ET. Monday through Friday. Enjoy the convenience of submitting forms electronically with Unum electronic signature forms.

  5. Download forms

    EN-1240. Group long term disability employee education flyer - employer paid. CS-1238. Individual Long Term Care Authorization Form (Billing/Policy Change) NY ER LETTER. Letter - Individual Long Term Care - Employer - New York. AE-8001-VT. Long Term Care Insurance Outline of Coverage - Indemnity. AE-8001-WA.

  6. PDF Assignment of benefits form

    balance. A photocopy of this assignment shall be considered as affective and valid as the original. I authorize the provider to initiate a complaint or file appeal to the insurance commissioner or any payer authority for any reason on my behalf and personally will be active in the resolution of claims delay or unjustified reductions or denials.

  7. Group long term care Plan administration guide

    Unum * benefits. Your contract specifies the employee group(s) or class(es) of individuals eligible for coverage under your Unum contract. Please refer to the Eligibility Section of your contract to determine who is eligible for coverage. After determining your plan's eligibility, distribute a packet of enrollment forms and any

  8. PDF TYPE OF ASSIGNMENT (Select one)

    RETURN COMPLETED FORM TO: Unum Life Insurance Company of America Attn: Group Life Benefits 2211 Congress Street , C-232 Portland, ME 04122 FAX: 207-575-7407 ASSIGNMENT OF LIFE INSURANCE ... Visit www.unum.com to obtain a copy of Form 133-63 Release of Assignment. FOR UNUM USE ONLY. ACKNOWLEDGEMENT OF RECEIPT IS NOT A VERIFICATION OF COVERAGE.

  9. Download forms

    AE-1241-CA-1. Accident Insurance Enrollment Form - California. AE-1241-FL. Accident Insurance Enrollment Form - Florida. AE-1241-LA. Accident Insurance Enrollment Form - Louisiana. AE-1241-NH. Accident Insurance Enrollment Form - New Hampshire. AE-1241-NJ.

  10. How to File a Claim with Unum

    The easiest way to file a claim or leave with Unum is online or with the mobile app. If your claim is for Disability Insurance benefits, check with your HR department at work to find out whether you can file over the phone. For all other benefits, you can call 1-800-635-5597 to file your claim.

  11. Unum Claims FAQs

    If you do not know how to contact your specialist directly, call 1- 800-858-6843 from 8:00 AM-8:00 PM Eastern Standard Time and one of our representatives will help you reach the right person. Commonly asked questions to claims information.

  12. Group Life Insurance Policies and Coverage

    Unum offers two main types of Life Insurance plans that can supplement your current coverage and offer more options to employees. Term Life provides financial protection for employees and their families during their working years. Whole Life provides coverage employees can keep into retirement — at competitive rates when they buy it early.

  13. Download forms

    Application - Disability Insurance - California. C-1339-NY. Application - Disability Insurance - New York. 1143-01-NH. Application - Evidence of Insurability - New Hampshire (FOR LIFE AND DISABILITY ONLY) NY1192-84. Application - Group Disability NY DBL.APP.1. 1102-06. Application - Select Conversion Disability Facts.

  14. Life Insurance Policies for Employees

    A Life Insurance policy can protect what matters most. Life Insurance can help your loved ones with financial obligations in the case of your death — from their daily expenses and mortgage to college tuition or retirement. Unum offers a range of policies for every stage of your life. Whether you're getting married, planning for a baby ...

  15. PDF Assignment of benefits

    IRS Form W-9. • Return both forms together to the address listed in the Return instructions at the end of this form. Sending the forms separately may . delay processing. • John Hancock will be unable to pay your provider directly unless we receive both forms in good order. Note: Benefits may not be assigned to an independent care provider.

  16. PDF How to file a claim for Unum benefits

    On the app 1. Download the MyUnum for Members app from either Apple ® or Google Play TM. 2. If you already have an account, you can log in. 3. If you do not have an account, select register.

  17. PDF Beneficiary Nomination (Expression of Wish form)

    However, you can say who you would like the benefit to go to. This is not binding on the Trustees. If you would like to nominate beneficiaries you should complete this form and return it to your employer to keep on your personnel file. Your latest form will be passed to the Trustees if you should die. You can complete a fresh nomination at any ...

  18. PDF Your Unum Voluntary Benefits Resources

    The Customer Contact Center can also help you if you need to cancel your policy. Unum will notify your Human Resources department at work if you make any changes to your benefits. Need to file a claim? Call our Customer Contact Center at 1-800-635-5597. A Customer Service Specialist will email you a claim form or help you download one from the ...

  19. Unum Vision Care

    Submitting a claim. To submit a claim, download the form linked below, complete it and return it to us along with a detailed receipt from your dentist. You can send it by any of the options below. Email here. Fax to 855-400-9307, or. Mail to: Claims Department. P.O. Box 80139.

  20. Long-Term Care Forms

    23046 Avenida De la Carlota Suite 600 Laguna Hills, CA 92653 (949) 859-4700. 5151 Oceanus Drive, Suite 102 Huntington Beach, CA 92649