Members you can quickly process your claim by downloading and completing your verification forms below:
Fully completed claim form signed by the insured
Medical Certification WH-380-F, or company equivalent
Once you've completed your verification forms upload them here:
Fill out my online form.Once you submit your claims information, all claims will be processed by Nationwide’s Third-Party Administrator, Disability Insurance Specialists, LLC.
You can also mail or fax your information by calling or sending it to: