Welcome to the Boston Mutual Life Insurance Company forms page, which provides you all of our Claim and Service forms in one convenient location.
Please select the form that best meets your needs. All of our forms open with Adobe Acrobat Reader. (Get Acrobat for Free by clicking here.)
Your completed forms should be mailed or faxed to us as directed on each form.
Our knowledgeable Claim Services staff is committed to providing you with a superior customer experience. At Boston Mutual Life Insurance Company, our insureds and clients are our priority.
For your convenience, our claim forms are available below.
If you are unable to locate what you need, please call our Claim Services department at 877.212.2950 and we’ll be happy to assist you.
Please select and download the correct claim form based on the type of coverage you have with us from the forms shown below.
In addition to downloading your claim form, you MUST also download the appropriate HIPAA-compliant Authorization form by selecting your appropriate state. If your state is not listed – Select standard HIPAA Authorization Form.
Please print the claim form and the HIPAA authorization and follow the instructions provided on the claim form.