Labor Union Benefit Services, Inc.
Teamsters 804 Members

Your Voluntary Benefit Administrators
Toll Free (877) 367-5827
Fax (732) 414-1840

If You Need to File a Claim, Call Our Office First

Claim forms can be sent to you via mail, fax or e-mail.
You are required to continue to make premium payments until you return to work, or you reach premium waiver. Once your claim form has been forwarded to the insurance company, call the insurance company directly at the number listed for status updates.

For UNUM CLAIMS:
  • Initial Claim:
    • Fill out pages 1, 2, and page 5. If the claim is for an accident, fill out section “A” on page 3.
    • Have the doctor who is taking care of you fill out page 4. The doctor must fill this form out completely.
    • Fax the form and your most recent paystub to (732) 414-1840 for employer verification.
  • Continuing Claim:
    • Fill out page 1. Sign the top of page 2 and the bottom of page 4.
    • Have the doctor who is taking care of you fill out page 3. The doctor must fill in dates of diability.
  • Call the office 10 minutes after your fax is completed to confirm we received all pages.
  • We will forward your claim form to UNUM.
  • Once you receive notice from UNUM that your claim is received, it can take up to 14 business days to process your claim (depending on claim volume).
For Paul Revere Claims:
  • Fill out pages 1, 2, 3, and 7. If this claim is for an accident, fill out section "C" on page 5.
  • The doctor who is taking care of you fills out page 4. The doctor must fill in dates of disability.
  • Fax the form and your most recent paystub to (732) 414-1840 for employer verification.
  • Call the office 10 minutes after your fax has been sent, to confirm we received all pages.
  • We will forward your claim form to Paul Revere.
  • It can take up to 14 business days to process your claim (depending on claim volume).
For Transamerica Claims:
Transamerica will not accept corrected forms. If a correction is needed, a new page must be used.
  • Fill out page 2. Sign the authorization on page 8.
  • If you live in New York, sign the "New York" Section on page 7. Otherwise, sign the "All Other States" box on page 7.
  • The doctor who is taking care of you fills out page 5. The doctor must fill in dates of disability.
  • If you are out because of an on the job incident, you MUST provide an initial injury report.
    UPS Safety Department phone # (212) 631-6153. You may have them fax the form direct to us.
  • Fax the form, your most recent paystub and injury report if needed to (732) 414-1840 for employer verification.
  • Call the office 10 minutes after your fax has been sent, to confirm we received all pages.
  • We will forward your claim form to Transamerica.
  • It can take up to 14 business days to process your claim (depending on claim volume).
For Allstate NY Claims:
  • Fill out pages 1, 2, and 3. If this is for pregnancy, fill out the top of page 4.
  • The doctor who is taking care of you fills out page 5. The doctor must fill in dates of disability.
  • Fax the form and your most recent paystub to (732) 414-1840 for employer verification.
  • Call the office 10 minutes after your fax has been sent, to confirm we received all pages.
  • We will forward your claim form to Allstate.
  • It can take up to 14 business days to process your claim (depending on claim volume).

If you send the claim forms to the fax number listed on the claim form, and the employer verification has not been filled out, your benefits may be delayed.

Insurance Company Numbers

  • First UNUM:
    (800) 375-8226
  • Allstate Life Insurance Company of NY:
    (866) 541-5794
  • Paul Revere Life Insurance Company:
    (800) 325-4368
  • Transamerica Financial Life Insurance Company:
    (800) 251-7254