Critical Illness Claim

To begin your claim, contact Midwest Heritage at 515-343-5047. A customer service representative will ask you for the following information to get the claim form started, and then mail the forms to you for completion.

  • Employee name, social security number, and store location
  • Current phone number, address and email address to contact claimant
  • When an employee receives the claim form from Midwest Heritage:
  • Complete the Critical Illness Claim Form
  • Attach copies of Itemized bills with diagnosis codes (a UB Form or 1500 Form works best)

If the critical illness is the cause of death, a claim form will be sent to the beneficiary upon notification of the death of the insured. A certified copy of the death certificate showing cause of death as a critical illness will need to be provided for consideration of claim.

Send complete the claim form with the appropriate itemized bills to Midwest Heritage Insurance, 1025 Braden Ave., P.O. Box 737, Chariton, Iowa 50049.

Products offered by Midwest Heritage Insurance Services are not insured by the FDIC or any other Federal Government Agency, are not a deposit or obligation of, or guaranteed by Midwest Heritage, may involve investment risks, including possible loss of principal amount invested, and may lose value.