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WebThe Hartford also provides administrative and claim services for employer leave of absence programs and self-funded disability benefit plans. Participant Accident Statement of Claim for Medical Expense Benefits Mail forms to: The Hartford One Hartford Plaza, T-14 Hartford, CT 06155 Fax: 1-866-954-3993 Telephone: 1-800-678-6702 WebHartford disability claim being administered by taking as disability the hartford forms your denial allows the hartford Department of Veterans Affairs as being capable of assisting claimants with their affairs before VA. It often happens that the plan administrator is the underwriting insurance company. Web1 Jul 2024 · TDI-45 Claim for Disability Benefit forms are not available online. Ask your employer for a claim form or contact us if your employer does not have the claim form. For employers: TDI-14 Equivalency Tables. TDI-15 TDI Self-Insurer’s Plan Certification and Agreement. TDI-62 This form can only be completed by TDI carriers. taunja rummer