Disability Claim Filing Instructions

Continental american Insurance company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands. For groups sitused in California, group coverage is underwritten by Continental american life Insurance company . For groups sitused in New York, coverage is underwritten by american family life assurance company of New York. Form # 1015 Disability Claim Filing Instructions Have 1. Completed the Employee s Statement in full? 2. Read, signed and dated the Authorization for Release of Information? 3. Had your Employer complete the Employer s Statement, and had it returned to you?

New York, coverage is underwritten by American Family Life Assurance Company of New York. Form # 1015 1 Fax 1 - (866) 376-9480 NOTICE OF CLAIM FOR SHORT TERM DISABILITY BENEFITS Toll Free Phone 1 - (888) 862-5732 LONG TERM DISABILITY BENEFITS EMPLOYEE’S STATEMENT

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  American, Company, Terms, Family, Life, Assurance, Short, Claim, Disability, Disability claim, Term disability, Short term disability, American family life assurance company

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