Please download and complete the form.


Email Completed form to claimsdepartment@neweralife.com

PRESCRIPTION REIMBURSEMENT

- Take a picture of the receipt on the bag.
-  Include your policy#
-  Email to claimsdepartment@neweralife.com 

ACCIDENT CLAIM FORMS

Download and complete
and email form.

SELF PAY
CLAIM FORM

Download and complete
and email form.

No Signature Required. 

CRITICAL ILLNESS CLAIMS

Download and complete
and email form.

GAP MEDICAL CLAIMS FORM

Download and complete
and email form.

MEDICAL EXPENSE CLAIMS

Download and complete
and email form.

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