Weband including consultation reports, to Great-West Life for the purpose of investigating and assessing my claim(s), administering ... Part 2: Attending Physician’s Statement. 1. … WebAttending Physician’s Report Ask your doctor to complete the form that is most appropriate to your claimed condition. If you have undergone any ... When your employer gives you this brochure, he/she will submit an employer’s statement to Great-West Life. This statement confirms your effective date of insurance coverage, job information ...

What Is an Attending Physician Statement for Life Insurance?

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Long-Term Disability Employee’s Statement Income Benefit

WebEmployer Statement. · Attending Physician Statement (pages 9-10): Please give this section of the claim form to the physician or treating provider primarily responsible for your care. Ask him/her to fax the completed form to 1-800-447-2498. If s/he prefers, it may be mailed to the address noted above. Unum Online Services WebMadison National Life Insurance Company, Inc. P.O. BOX 2865 CLINTON, IA 52733-2865 Telephone: 800-356-9601 Extension 2410 Fax: 608-830-2701 ATTENDING PHYSICIAN’S STATEMENT THIS IS A TIME SENSITIVE DOCUMENT ... Nebraska, Nevada, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Texas, Utah, … imagesource from file