Wellness Claim

TO File a Wellness Claim by mail or fax:

Please submit this completed Wellness Claim form along with a detailed statement from the medical provider showing the type of test and date performed.

Click here to download the form

The Wellness Benefit is payable only once per calendar year per Covered Person
Qualifying tests are: Mammogram; Pap Smear; PSA; Colonoscopy; Biopsy; Breast MRI or Ultrasound; CA125; CA 15-3; CEA; Chest X-ray; Flexible Sigmoidoscopy; Hemoccult Stool Specimen; Testicular Ultrasound, Thermography or Thin Prep; Serum Protein Electrophoresis; or Virtual Colonoscopy.

Mailing address: Life Insurance Company of Alabama
  Attn: Wellness Claims
  PO Box 349
  Gadsden, AL 35902
   
Or FAX to: 256-399-0252

TO File a Wellness Claim by phone:

LICOA provides phone in wellness claims as a courtesy to our policyholders. You may be required to provide us with additional written information in regard to the claim. Please check your policy. Not all LICOA policies have a Wellness Benefit.

BEFORE YOU CALL...

ONLY Covered Persons over the age 19 may file a wellness claim over the phone.

We must speak to each covered person who received a qualifying medical test. You cannot file a Wellness claim on someone else’s behalf. Benefits are payable to the Primary Insured named in the policy.

You need to know the following information:

  1. The LICOA Policy Number.
  2. The type of medical test performed.
  3. The date the test was performed.
  4. The doctor's name that ordered or performed the test.
  5. The doctor's address and phone number.

Call our Customer Service Department at 800-226-2371 or 256-543-2022.


To Protect any personal or family Information, Please do NOT send by EMAIL:

  • Any confidential, personal, or sensitive information.
  • Social Security Numbers or Driver’s License Numbers
  • Claims or other policy related documents
  • Health information.

Life Insurance Company of Alabama is not responsible or liable for any loss due to information sent to us by email. By sending us any information by email, the sender takes full responsibility and liability for the information contained within the email.