Customer Administration Forms

Claim Forms

Claim Submission Information - Equitable Life and Disability

Claim Submission Information - DBL and PFL

Life and W-9

Life Waiver of Premium

Accelerated Death Benefit

STD Telephonic Intake

STD

LTD

Dental

Vision

 

Customers with both DBL and STD

For customers that have both STD and DBL coverages through The Business Council, please submit the AXA STD claim form to both Maxon(DBL) and AXA(GRP).  Your e-mail notification should include both vendors so that each can coordinate their claim efforts.

 

DBL/PFL