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DoverPhila Federal Credit Union

To report a claim or request a benefit activation, select the form that best describes your situation.
Follow the instructions and complete the required fields to ensure timely processing.
If you need assistance in identifying the correct form or assistance in completing a form, please call the Pekin Insurance Financial Products Benefits Center at 1-800-322-1060, Extension 2329.
Benefit Activation Request – Death   CL 1010
Benefit Activation Request – Unpaid Family Leave   CL 1011-25
Benefit Activation Request – Involuntary Unemployment   CL 1013-1
Benefit Activation Request – 30 Day Disability   1015-30R-25 HRS (11-07)
HIPAA Authorization – Ohio Authorization LU129OH

Call Toll-Free 1-800-322-0160