File a Cancer Claim

 

To begin your claim, contact Midwest Heritage at 515-343-5047 or [email protected]. 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 Cancer Claim Form in its entirety.
• In order to document the contents of the form, the Insured and Claimant (if an adult) must sign and date the completed claim form.
• Please have the treating physician complete the Attending Physician Statement.
• Please have your physician provide the applicable documents in order to avoid a delay in processing.

 

Send the completed claim form with the appropriate itemized bills to:
Midwest Heritage
1025 Braden Ave.
Chariton, Iowa 50049

Fax: 641-774-2022
Email: [email protected]

Depending on the facts and circumstances relating to your condition, additional information may be required to process your claim.