Group Claim Forms
Our knowledgeable Claims staff is committed to providing you with a superior customer experience. At Boston Mutual Life Insurance Company, our insureds and clients are our priority. For your convenience, our claim forms are available below. If you are unable to locate what you need, please call us at 1-877-212-2950 and we’ll be happy to assist you.
If you are an employer needing forms to file a claim for group life and/or disability, or a third party administrator who administers group benefits, please select from the following list of forms.
In addition to downloading your claim form, you MUST also download the appropriate HIPAA-compliant Authorization form by selecting your appropriate state. If your state is not listed – Select standard HIPAA Authorization Form.
You must review and print our Notice of Information Privacy Practices for your records.
All of our forms open with Adobe Acrobat Reader. Get Acrobat for Free
Disability Claim Forms
If you are unsure of the specific Disability Income form you need and do not have your group number available, please contact Claim Services at 1-877-212-2950.
Group Service Forms
Our knowledgeable administrative staff is committed to providing you with a superior customer experience. At Boston Mutual, our insureds and clients are our priority. For your convenience, many of our policy change and service forms are available here. Please select the form that best suits your needs. If you are unable to locate what you need, please contact a Group Representative at 1-800-669-2668, ext 700 and we’ll be happy to assist you.