Symetra Life Insurance Company Hospital Indemnity Insurance How to file a claim Your policy information Policy #: Policyholder: Option 1 Use My Group Online ( MyGO ) Initiate a claim in minutes on MyGO . This secure, user-friendly platform is available 24/7 through your computer or mobile device. To submit your claim: 1 Register your account at symetra.com/MyGO . Log in and select Submit my claim . 2 Fill out a few simple fields and upload documents. 3 Select Submit. With MyGO, you can also: Check the status of a claim. View an Explanation of Benefits (EOB) and enroll in paperless statements. Download important forms. Submit scans, photos or electronic versions of claim documents. Enter banking information to receive ACH benefit payments. Option 2 Email, mail or fax a claim 1 Request an itemized bill (form UB-04 or HCFA 1500) from your provider with diagnosis and procedure codes. 2 Write a statement describing the date, place and cause of the hospital stay. 3 Complete a claim submission form, which can be found on MyGO under Forms. We can also email, mail or fax this form to you. 4 Submit the above information to Symetra by email, mail or fax. Continued > SBM-6524 7/25