How to File a Life or Accidental Death and Dismemberment Claim

How to 昀椀le a life or accidental death and dismemberment claim. For employers. BEFORE YOU FILE YOUR CLAIM CLAIM 1 FILE THE CLAIM 2CLAIM 3REVIEW 4APPROVAL 1. Visit nyl.com/customer-forms to Choose one of the following: A life or AD&D claims specialist will If the claim is approved, we will notify download and complete form(s). Email: (preferred) Send scanned documents be assigned: you and send an approval letter to Click Submit a Life, Accidental Death to Claims.Pghlif2@newyorklife.com. • If they have any questions or need the beneficiary. and Dismemberment or Waiver Claim additional information, they will contact The benefits include*: Online to begin. Fax: (877)300-6770 Mail: you or the bene昀椀ciary. – Survivor Assurance account including – Read and agree to the state • After we receive all requested information, the ability to write an unlimited number fraud warnings. New York Life Group Bene昀椀t Solutions a claim decision will be available within of drafts on the account. – Follow the steps to complete the (NYL GBS) Life & Accident Claim Services 10 business days. claim form. P.O. Box 22328 Pittsburgh, – NYL GBS Life Assistance Program for PA 15222-0328. bereavement counseling. 2. For claims involving death, By phone: (800) 362-4462 – My Secure Advantage financial you will need to provide: between 7:00 am – 7:00 pm CST. Prompt #4. Claims should be reported wellness services. • All bene昀椀ciary designations on 昀椀le. as early as possible. Standard Online: nyl.com/customer-forms. policy provisions call for the • If the claim is denied, we will notify you • Assignments, court orders, or any Blank/fillable claim forms can be found notification of claims within 31 and send the bene昀椀ciary a detailed other documents that may a昀昀ect online at nyl.com/customer-forms. days of the date of loss and letter explaining why the claim was payment. denied and instructions on how to • A copy of the death certi昀椀cate. • Download, print, complete, sign your “proof of loss” within 90 days. appeal the denial. • Life insurance enrollment forms claim form and send via fax, email or mail. Our customer representatives for voluntary bene昀椀t. are here to help you. 3. For AD&D insurance claims, as well Call (800)238-2125. as some life insurance claims, we may ask for reports, such as a police or medical examiner report, if available. *The Survivor Assurance program for beneficiaries is available to beneficiaries receiving coverage checks of $5,000 or more from New York Life Group Benefit Solutions. Phone and face-to-face counseling sessions must be used within one year of the date the claim is approved. Survivor Assurance accounts are not deposit account programs and are not insured by the Federal Deposit Insurance Corporation or any other federal agency. Account balances are the liability of the insurance company and the insurance company reserves the right to reduce account balances for any payment made in error. Counseling, legal or financial assistance programs are not available under policies insured by New York Life Group Insurance Company of NY. These programs are NOT insurance and do not provide reimbursement for financial losses. Some restrictions may apply. Not available in NY. Programs are provided through third party vendors who are solely responsible for their products and services. Full terms, conditions and exclusions are contained in the applicable client program description and are subject to change. Program availability may vary by plan type and location and are not available where prohibited by law. New York Life Group Benefit Solutions products and services are provided by Life Insurance Company of North America and New York Life Group Insurance Company of NY, subsidiaries of New York Life Insurance Company. New York Life Insurance Company, 51 Madison Avenue, New York, NY 10010 © 2021, New York Life Insurance Company. All rights reserved. NEW YORK LIFE, and the NEW YORK LIFE Box Logo are trademarks of New York Life Insurance Company. 937369 a 0621 SMRU 1904834 Exp. Date 06.24.2023