Combined Insurance Claim Form - Combined insurance claim department p.o. Filing a claim by mail. Web important instructions for filing claim for disability/loss of time the form must be completed in detail including the employer’s statement in section c. However, you cannot submit the information electronically. Print all pages of the claim form. Follow first page instructions below and upon completion of the first page, print the document (which will be 2 pages). Your claim is processed ten days faster* when you submit a claim online at www.combinedinsurance.com/claims. © 2016 combined insurance company of america (chicago, il). For more information please visit the policyholder center at www.combinedinsurance.com. Web policyholder center, policyholders can file a claim by mailing completed claim forms to:
© 2016 combined insurance company of america (chicago, il). For more information please visit the policyholder center at www.combinedinsurance.com. Complete all sections of the claimant statement. You can complete the claimant information (first page) online; However, you cannot submit the information electronically. Your claim is processed ten days faster* when you submit a claim online at www.combinedinsurance.com/claims. Follow first page instructions below and upon completion of the first page, print the document (which will be 2 pages). Filing a claim by mail. Combined insurance claim department p.o. Web important instructions for filing claim for disability/loss of time the form must be completed in detail including the employer’s statement in section c. Web policyholder center, policyholders can file a claim by mailing completed claim forms to: Print all pages of the claim form.