Compass Accident Insurance Claims

There are different types of Accident Insurance coverage available. Please verify what coverage is available under your group policy, if any, before selecting from the claim forms below.

Compass Accident Insurance Claims

Please distribute the claim form to the insured. The Consumer Privacy Notice is attached.

Note: If the employer has submitted enrollment data electronically, the Employer form below does not need to be completed

Form NameForm Number

Compass Accident Insurance Claim - Employee (with Consumer Privacy Notice 47316c attached) for group policies issued in all states except New York

167312 (2/7/14)

Compass Accident Claim  - Employer (with Consumer Privacy Notice 47316c attached) for group policies issued in all states except New York

165759 (11/11/13)

To submit a Wellness Benefit Rider Claim:

Please distribute the claim form to the insured. The Consumer Privacy Notice is attached.

Form NameForm Number

Wellness Benefit Rider Claim Employee (with Consumer Privacy Notice 47316c attached) for group policies issued in all states except New York

165760 (07/01/2014)