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myNISI

Noridian Insurance Services, Inc.
  • myNISI >
  • Forms

Accident Claim

  • Accident Claim Form
  • AccidentPlus Claim Form
  • Policy Change Form
  • Authorization for Release of Medical Information

Cancer and/or Specified Disease Claim

  • Cancer and/or Specified Disease Claim Form
  • Policy Change Form
  • Waiver Of Premium
  • Authorization for Release of Medical Information

Critical Illness Claim

  • Cancer, Carcinoma in Situ – Cancer Claim Form
  • Heart & Stroke Claim Form
  • Beneficiary Change Form
  • Policy Change Form
  • Authorization for Release of Medical Information

Hospital Indemnity and/or ICU Claim

  • Hospital Indemnity Claim form
  • Authorization for Release of Medical Information
  • Beneficiary Change Form
  • Policy Change Form
  • Waiver Of Premium

Short-Term Disability Claim

  • Short-Term Disability Claim Form
  • Short-Term Disability Update Form
  • Policy Change Form
  • Waiver Of Premium

Long-Term Disability Claim

Contact USAble Customer Service at 800-648-0271 for exact form.

Life claim – 10 Year Term or Universal Life Insurance

  • Death Claim Form (Universal Life)
  • Death Claim Form (10 yr Term)
  • Beneficiary Change Form
  • Policy Change Form
  • Waiver Of Premium
  • Authorization for Release of Medical Information

Lincoln Mutual Voluntary Group Term Life Insurance

  • Claim Form and Employer’s Statement
  • Portability Application ND residents
  • Portability Application MN residents
  • Change Form
  • Request For Service
  • Beneficiary Change Form
  • Waiver Of Premium

For any claim forms not listed, please contact Noridian Insurance Services, Inc at 800-575-9643 or 701-277-2049.

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