Submit a Claim

Welcome! This is a fast, secure way for you to initiate a benefits claim for yourself, a family member or – if you are an employer – a covered employee. Note that you will need some general information in order to begin this claim process. This might include:

  • Employer Name / Address
  • Employee Name / Address / Gender / Date of Birth / Phone / Social Security Number
  • Employee Date of Hire
  • Salary information
  • Last day worked
  • Injury/Condition
  • Physician information
  • Tax Withholding Information (Whether or not to withhold taxes from benefit payments)

You may also need to complete an additional Authorization to Obtain Information, which allows us to request your medical records if needed. If you would like your benefit payment deposited electronically into your bank account, we will also need you to complete an Authorization for Electronic Fund Transfer.

After we receive your claim submission, a Reliance Standard Claims Examiner will reach out to you, typically within 48 hours, to:

  • Verify the reasons for your claim
  • Gather any additional information needed to make a decision
  • Discuss your plan/benefit coverages and discuss the next steps in the decision process