The form numbers can be found at the bottom of the page. Medicare Supplement Insurance Policy Insurance designed The benefit for an accidental bodily injury is payable to an insured as long as the treatment is received within 72 hours from a qualified institution as defined by the policy. Life Insurance Globe Life Insurance Company of New York offers two different life insurance options. Due to confidentiality, claims cannot be accepted through our website or by email. Many times the UB-04 or 1500 Health Insurance Claim Form will include diagnosis codes; however, these codes are not always fully descriptive of why the visit to the ER or physician took place. Policyholders do have the ability to update beneficiary information at any point during the life of the policy. ALWAYS REFER BACK TO YOUR POLICY FOR FURTHER INFORMATION REGARDING BENEFIT QUALIFICATIONS. We will walk you through the process of getting coverage today! Printable claim forms are available for your convenience. Certified Death Certificate (including cause and manner of death) If your benefit amount is $10,000 or less a copy of Death Certificate is allowed. If you have questions or need assistance with filing your claim, please contact our Life Insurance Claims Line at (440) 922-5160. We Offer No-Money-Down Representation for Globe Life Insurance Should there not be an estate in place, we will require a document from the courts stating as such. Typically, you will receive your check within 10 – 15 business days from the time your claim was processed and all required information has been received. A UB-04 is typically a summary associated with hospital stays. Product availability and features vary by state and subsidiary. For any policy less than two years old, the claim may also be subject to further review. These forms are completed by and obtained from the provider in which the treatment was sought. Switch to Chrome, Firefox, or Edge for the best online experience. Complete the Patient/Claimant section and have the physician complete the Physician Statement. ALWAYS REFER BACK TO YOUR POLICY FOR FURTHER INFORMATION REGARDING BENEFIT QUALIFICATIONS. Globe Life is dedicated to providing life and supplemental health insurance to help protect your loved ones from financial stress so they can focus on what matters most. A printable form can be found here - Disability Claim Form. Globe life claim forms can be accessed here. These forms are completed by and obtained from the provider in which the treatment was sought. Globe Life Liberty National Division Attn: Policy Benefits P.O. Please mail the completed forms, along with the original Certified Death Certificate (including cause and manner of death), the obituary (if available),the original policy, and any other supporting documentation. Click on the links below for claims filing instructions, printable forms, and answers to your most frequently asked questions about filing a claim. **Definition of an accident may vary by policy. How do I obtain a certified death certificate? The following conditions are not covered: If you suffer a disability that keeps you from maintaining employment and this is the first time you are applying for Disability, please print and fill out the claim form and send it to the following address: Click here for the printable claim form: Disability Claim Form. If you haven’t received your check within 30 days of the date your claim was processed, please contact our Claims Department at (440) 922-5151. Printable claim forms can be found below: Please also include a copy of the CMS 1500 or UB-04 form (only associated with hospital stays) and any itemized medical bills you would like to have considered for payment. A CMS 1500 is normally associated with clinic or physician visits. 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