Thank you for being a valued LifeMap partner. In January 2022, LifeMap was acquired by Life & Specialty Ventures, L.L.C. (LSV), the parent company of USAble Life. USAble Life is a leading national provider of voluntary and employer-sponsored supplemental, life and disability coverage.

To submit a claim, a list of claim forms may be found below. For Dental Providers, submit a digital claim.

 

Find Your Form

 

Title

Download

Accident Claim Form

Download Form

Accidental Dismemberment Claim Form

Download Form

ADA Dental Claim Form

Download Form

Assignment of Life Insurance Proceeds Form for Life Claim Benefits

Download Form

Critical Illness Cancer Care Claim Form

Download Form

Extended Life Insurance Claim Form for Employee

Download Form

Extended Life Insurance Claim Form for Spouse

Download Form

Individual Vision Rider Reimbursement

Download Form

Life Insurance Claim Form

Download Form

Long Term Disability Claim Form

Download Form

Notice of Privacy Practices

Download Form

Privacy Notice

Download Form

Short Term Disability Claim Form

Download Form

Wellness Benefit Statement

Download Form