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How to submit a claim
First, you will need to fill out the claim form below. A few key things to remember:
- Please provide as much information as possible.
- All fields are required unless marked optional.
- A claim cannot be submitted without the required fields completed.
- Click the “Next” button at the bottom of each page to save your information.
- In the last step, you’ll be able to review and print all the information you’ve provided.
If at any time you have questions or need assistance, please call
You may also submit your claim by fax, email, or mail by downloading, printing, and completing one of these claim forms:
Accidental Injury [PDF] Critical Illness [PDF] Hospital Care [PDF] Wellness Incentive [PDF]
Note: Based on higher than normal claim volumes, please allow additional time for review.
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Cigna Company Information
Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., and Cigna HealthCare of North Carolina, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see