Claim Type

Claim Type
User Details
Claim Details
Supporting Documents
Review
Confirmation

Welcome to the Claims Entry site. Please enter details below to submit your claim.

Type of Claim

Is this claim for an Employee or Dependent? Employee Dependent

Type of User

Please retype the characters from the picture

CAPTCHA

Change the CAPTCHA code

Speak the CAPTCHA code

Your input doesn't match displayed characters.

Attach file to existing Claim

Please wait..

If you do not have all of the required information, you can call our Customer Service number Life & Disability: 800-843-8184 to see if we may be able to assist you with filing the claim.

Life and Disability products underwritten by UniCare Life & Health Insurance Company. ® Registered mark and SM service mark of WellPoint, Inc.