TransAmerica Employee Voluntary Benefits Claim Process

Instructions for Submitting a TransAmerica Self-Administered Accident, Critical Illness, Hospital Indemnity Claim Process

This Health Claim Package consists of multiple parts. When filling out each package section, please remember to provide complete and accurate information. If you make a claim on your dependent who is over the age of 18, the claimant (patient) needs to sign and date the HIPAA Authorization for the Release of Health-Related Information (“HIPAA Authorization”) – you cannot sign for the dependent. It’s important to note that each claim type’s list of forms and information is generic. Please call the Contact Center at (855) 244-8318 for a copy of your certificate benefits to help determine what else you need to submit for consideration.

Please reference the following specific product number for the type of claim being processed. This number must be included on the claim form.

• ACCIDENT PRODUCT NUMBER: BG 000084427
• CRITICAL ILLNESS PRODUCT NUMBER: BF 00084429
• HOSPITAL INDEMNITY PRODUCT NUMBER: B 100084428

Accident* Claimant’s HIPAA Authorization showing actual charges/expenses for medical treatment or diagnosis. (Accident Wellness Benefit is only applicable to adults)
Critical Illness* Claimant’s Statement, Attending Physician’s Statement, HIPAA Authorization, diagnostic reports (pathology report if cancer-related), discharge summary, or other medical records indicating the condition and date of diagnosis.
Hospital Indemnity* Claimant’s Statement, Attending Physician’s Statement, HIPAA Authorization, and an itemized hospital or UB04 statement.
Wellness Screening Benefit* You must only submit statements or medical records from the physician or hospital showing the date and procedure performed. No additional documents are necessary; remember to include the product number. 

Instructions for Submitting a TransAmerica Cancer Select Plus / Universal Life and Term Life claims

Cancer Select Plus HOW IT WORKS:

• Pays benefits directly to you.
• Spouse and dependent benefits available.
• Payroll-deducted premiums.
• Easy enrollment process.

Cancer Select Plus – Annual Cancer Screening: Pays per calendar year for the following cancer screening tests (This benefit only applies to adults):

• Mammogram
• Pap smear
• Flexible sigmoidoscopy
• Prostate-specific antigen
• Test
• Chest x-ray
• Hemocult stool specimen
• Ultrasound
• CEA
• CA125
• Biopsy
• Thermography
• Colonoscopy
• Serum protein
• Electrophoresis
• Bone marrow testing
• Blood screening

When filing a Cancer Claim* Claimant’s Statement, Attending Physician’s Statement, HIPAA Authorization, and pathology report diagnosing cancer. Itemized provider statements with actual charges/expenses (**) incurred for the treatment.

Transamerica Universal Life Insurance provides a cash benefit after death that can assist with final expenses, dependents’ care, living expenses, or college tuition. You had the choice between two types of life insurance coverage: a 10 or 20-year term life plan and a new Program that is a Permanent Life policy with Long Term Care benefits. These options give the flexibility to select the coverage that aligns with your individual needs and circumstances.

Please note—Universal Life and Term Life claims: The beneficiary or employer should contact customer service at 888-763-7474. Once the death notification is received, the claim team will mail the beneficiary the claim packet. This packet has instructions for submitting a claim. The policy number must be listed on the claim form.

Please reference the following specific product number for the type of claim being processed. This number must be included on the claim form.

• CANCER SELECT PLUS PRODUCT NUMBER: CN00084529 
• TRANSAMERICA UNIVERSAL LIFE PRODUCT NUMBER: FP00084436
• TRANSAMERICA 10-YEAR TERM LIFE PRODUCT NUMBER: T100084434
• TRANSAMERICA 20-YEAR TERM LIFE PRODUCT NUMBER: T200084435