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Documents

HIPAA Authorization

GENERIC HIPPA AUTH
ARIZONA AUTH
MINNESOTA AUTH
OHIO AUTH
VIRGINIA AUTH

Credit Insurance Claim Forms

LK14 (03-17) - Notice of Claim for Death Benefits
LK15-16 (02-20) - Disability Initial Claim Form 

Debt Protection

CL 1009 (11-07) - Accidental Death Benefit Activation
CL 1010 (05-20) - Death Benefit Activation
CL 1011 25 (11-07) - Unpaid Family Leave Benefit Activation
CL 1011 (05-20) - Unpaid Family Leave Benefit Activation
CL 1013 (05-20) - Involuntary Unemployment Benefit Activation
CL 1015 (05-20) - Disability Benefit Activation
CL 1015-30R-25HRS (11-07) - Disability Benefit Activation
CL 1019 (05-20) - Hospital Benefit Activation