Bankers Life and Casualty - For the life of your retirement

Find Your Local Bankers Office
Zip Code:
Bankers Life on Facebook Bankers Life on LinkedIn Bankers Life on YouTube
Home About Us Products Careers Service/Claims Providers Contact Us  
Service/Claims Page - photo Service and Claims
Dedicated to Serving You
     
Service/Claims
Claim Forms
Service/Claims FAQs
Nursing Home Help
Retiree Resources
Email Us
Fraud Referrals
Upload a Document

Claim Forms

To download a claim form, select the state and policy type from the dropdown boxes below. Complete the form and mail it to the address provided in the form.

Please select state where
care is being provided:

 
Please select the
type of policy:

 
 

Independent Caregiver Forms

For use with all private-hire independent caregivers.

The Independent Caregiver Packet includes Proof of Payment Requirements, Release of Liability, Caregiver Biographical and Qualifications information, and itemized Billing Statement and Daily Visit Notes. Click here to download.

To download the stand-alone Itemized Billing Statement and Daily Visit Notes form click here

Questions? Click here to review claims FAQ's.

Please note: These forms are PDF files. In order to view or download any PDF files, you will need Acrobat Reader software. If you do not have Acrobat Reader and wish to download it for free, click here to visit the Adobe Acrobat Reader website.

 
     

    Site Map | Legal | Privacy  
 
  50135 (06/26/12)  
    Copyright © 2014, Bankers Life and Casualty Company. Chicago, IL. All Rights Reserved. (2.0.83.13)  
Text Size: