Whether you need to change your beneficiaries, check on the status of a claim or any other concerns, we are here to assist you.

File an Insurance Claim - Standard Premiums

When you need us most, the last thing you want is a difficult, drawn out claim process. That's why Combined Insurance is different ... we strive to make it easy to file insurance claims.

To file Combined Insurance claims for standard premiums*, print the Claim Form Instructions, then simply click on your state of residence from the following list and print out the appropriate form. (If your premium is paid through your employer using PAYROLL DEDUCTION, CLICK HERE.) Complete the form; specific sections must be completed by your employer and doctor, and return the form to us at:

Combined Insurance
Claim Department
P.O. Box 6700
Scranton, PA 18505-0700

NOTICE OF COMPLIANCE WITH EMERGENCY BULLETINS ISSUED BY RHODE ISLAND

RHODE ISLAND POLICYHOLDERS: If you were affected by the storms/flooding that occurred in March of 2010 and you reside in a county that has been declared a disaster area by federal and/or state government(s) please note Combined Insurance is providing a 60 day payment extension for premium payments due between March 1, 2010 and May 31, 2010. Combined Insurance is also providing policyholders impacted by the March storms/flooding with a 60 day extension of any time limit imposed by other policy provisions or notices relating to your Combined insurance coverage or claims. If you have any questions please call 1-800-225-4500.

Claim Form Instructions

U.S. Form (All States with the exception of New York)
English / Spanish

New York Form
English / Spanish

Claim Forms

 

 

*If your premium is paid through payroll deductions, please click here.

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