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.
P.O. Box 737
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.

Legal Disclosures and Information

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.