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Claim Forms
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PCA-Rx Precertification Request Form
PCARx_Prior-Authorization-Request-Form-for-Contact-Center_09-14-2022.pdf 247.08 KB (Last Modified on February 10, 2023) -
American Fidelity Physician Expense Disability Claim Form (1 Day)
2019 - American Fidelity - Physician Expense Benefit Statement Disability Claim Form.pdf 175.7 KB (Last Modified on December 11, 2020) -
Allstate Cancer-heart-Stroke Claim Form - Individaul Plans
Allstate Cancer-Heart-Stroke Claim Form - Individaul Plans.pdf 190.38 KB (Last Modified on August 9, 2019) -
Disability Forms - Instructions for Disability Claims
If you have any questions regarding your disability benefits through American Fidelity Assurance Company, please call our First Financial Agent, Morgan Harris, at (432) 456-9783 or (432) 556-4172.
2019 - American Fidelity - Regular Disability Claim Form.pdf 1.65 MB (Last Modified on August 3, 2019)