Rates & Plan Information

Decreases to existing coverage are allowed at anytime. 

To decrease coverage, complete the Request for Service Form and submit via secure file upload here.

Cancellations are allowed at anytime. 

To cancel coverage, complete the Notification of Cancel Form and submit via secure file upload here.

Complete the Request Duplicate Certificate Section of the Request for Service Form and submit via secure file upload here.

Complete the Tobacco or Nicotine Use Questionnaire and submit via secure file upload here.

Complete the Beneficiary Change Form and submit via secure file upload here.

Complete the Address Change Section of the Request for Service Form and submit via secure file upload here.

Complete the Name Change Section of the Request for Service Form and submit via secure file upload here.

For use by policyholders who are currently on direct billing via monthly automatic payment with Chubb and need to make one of the following changes.

• Change bank account
• Need to correct bank account
• Change the date of their withdrawal

Complete the Authorization for Deductions From My Bank Account Form and submit via secure file upload here.

• Long Term Care Claim Form: Click Here
• Life Insurance Claim Form: Click Here
• Beneficiary Statement: Click Here
• Claims FAQ Document: Click Here

Via Phone: A customer service specialist can help you file your claim and answer claims-related questions you may have. Call: 1-855-241-9891

Via E-mail: E-mail a claims service specialist at claims@gotoservice.chubb.com to start the claim filling process.

Via Paper: After requesting forms be mailed to you, you can file a claim by mailing the completed paperwork to:

Mail: Chubb, Claim Admin Office, One Integrity Parkway, Cleveland, OH 44143-1500

Fax:   1-603-352-1179

Custom Colors and Fonts

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