NEW YORK DISABILITY/PAID FAMILY LEAVE CLAIMS
Please submit the following forms within 30 days of the start of the disability:
Notice and Proof of Claim for Disability Benefits
If your disability policy includes an In-Hospital Rider and the claim involves a hospital stay, please also submit the form below:
In-Hospital Statement of Claim
If your disability policy includes an Accidental Death & Dismemberment Rider and the claim involves such an scenario, please also submit the form below:
Accidental Death & Dismemberment Claim Form
For claims involving paid family leave, please submit the following forms within 30 days of the expected leave (as known):
Paid Family Leave – Bonding with New Child
