Most claims get filed using the same three steps:
- Download and print the claim form
- Print and complete the form
- Mail your completed claim forms to the appropriate office
The details, and the right claim form, will depend on the type of claim.
Mental Health and Substance Use Claims
Mail claims for mental health and substance use treatment to:
Cigna Behavioral Health, Inc.
Attn: Claims Service Dept.
P.O. Box 188022
Chattanooga, TN 37422
Download a dental claim form:
Mail your completed claim forms, with original itemized bills attached, to Cigna Dental:
P.O. Box 188037
Chattanooga, TN 37422
- Contact your employer. On or before your first day out of work, let your employer know when and for how long you expect to be absent from work.
- Contact us.
- For short-term disability, if you know that you will be out of work for more than seven days in a row, let us know before your seventh day out of work by filing a claim over the phone or by completing and returning the claim form online, by fax, by email or postal mail. If your plan* allows for coverage before seven days, report your claim as soon as possible.
- For long-term disability, when possible, notify us at least 30 days before you will be unable to work. In the event that your need for long term disability benefits is not because of a planned procedure or treatment, contact us as soon as possible. If Cigna has already approved your claim for short-term disability coverage, the claim will automatically be started for you.
- Your health care provider’s (doctor or hospital) name, address and telephone number
- Your last day worked, or date of injury or onset of illness
- The dates of your first, last and next visit to the doctor
- Your supervisor’s name, telephone number and email address
- The amount of money (if applicable) you are receiving from other sources (e.g., Workers’ Compensation, Social Security, state disability, or pension)
You can submit your claim in a few ways:
- Submit a disability claim online. Complete the online form and we'll call you if we need additional information.
- Call us
1 (800) 36-Cigna (362-4462) or
1 (866) 562-8421 for Español
Monday through Friday, 7:00 a.m. to 7:00 p.m. CST
- Submit a disability claim by fax, email, or postal mail:
- Download the short term disability form [PDF] or long term disability form [PDF]
- Print out the form and the Physician's Statement [PDF],
- Complete, sign and mail or fax your claim form to:
Cigna Disability Management Solutions
Paper Intake Team
P.O. Box 709015
Dallas, TX 75370-9015
Fax: 1 (800) 642-8553
- Email: claims.pghlif2@Cigna.com
It may be necessary for us to obtain additional information or clarification from your employer and your health care provider. If you have not done so, please complete a Disability Disclosure Authorization form [PDF]. This form grants us access to the information necessary to process your claim.
Send your Disability Disclosure Authorization form to the office that manages your claim. Please contact your Human Resources Representative to confirm the office that is managing your claim.
Eden Prairie, MN
All disability claim forms and related forms
- Short Term Disability Benefits [PDF]
- Long Term Disability Benefits [PDF]
- Educator Disability Benefits [PDF]
- State Income Tax Voluntary Withholding Request Form [PDF]
- Federal Income Tax Withholding Request Form [PDF]
- Electronic Fund Transfer (EFT) Authorization Form [PDF]
- Verbal Authorization Information Form [PDF]
Have a question? Call 1 (800) 36-Cigna (362-4462) between 7 am and 7 pm Central Time.
Life, accidental death & dismemberment, or waiver claim
If your employer offers and you are enrolled under a Cigna Group Life or Accidental Death and Dismemberment (AD&D) policy, you, your beneficiary or other designated representative can file a claim. It's important that you provide us with complete and accurate information to avoid a delay in the processing of your claim.
You may also need to submit a Disclosure Authorization [PDF] to authorize health care providers to give information about the insured.
You can submit your claim in one of two ways:
- Submit a life, accidental death and dismemberment or waiver claim online.
Complete the online form, and fax the supporting documentation.
- Submit via fax or mail. Download, print, complete, sign and mail, or fax your claim form.
- Proof of Loss Life Insurance Accidental Death Claim [PDF]
- Proof of Loss Accidental Dismemberment Claim [PDF]
- Proof of Loss Accidental Dismemberment / Accidental Injury / Accidental Disability Claim [PDF]
- Proof of Loss Health Screening Claim [PDF]
- Proof of Loss Hospital Care Claim [PDF]
- Critical Illness/Hospital Care Extension of Benefits/ Waiver of Premium [PDF]
- Life Insurance Accelerated Benefits Claim [PDF]
- Universal Life Insurance Claim Form [PDF]
- Total and Permanent Disability/Waiver of Premium [PDF]
Have a question about your claim form?
Call Cigna Group Insurance® at 1 (800) 238-2125 between 8:00 a.m. and 5:00 p.m. EST. If you call outside this time frame, please leave a voicemail message, and a representative will respond the next business day.