Submitting Life and AD&D Claims

To submit a claim for life and AD&D benefits, participants in a life and AD&D plan should review the claims section of their SPD.

In the event of a death, the employee's beneficiary must mail a certified copy of the death certificate to the Fund Office. If the death was accidental, the beneficiary should include a copy of the police and autopsy reports, including a toxicology report, if necessary.

For an accidental dismemberment, the employee must submit written details of the accident along with confirmation from a physician of the related injuries.

The Fund will complete the necessary claim forms and send them to the employee or the beneficiary for signature. Once the forms are signed and returned, the Fund will forward the claim to The Hartford for processing. Life insurance benefits will be paid to beneficiaries. Accidental death & dismemberment benefits will be paid to the employee or to beneficiaries, as applicable.

You or your beneficiary must submit a life and AD&D claim within one year after the death or injury in order for the claim to be processed.

Mail or fax necessary certificates and reports to the Fund Office as follows: