Free Insurance Claim Forms and Templates

What Is an Insurance Claim?

An Insurance Claim Form is a formal written request that a policyholder submits to their insurance company (or government entity) to request coverage or compensation for a covered loss or policy event. The insurance company reviews the Insurance Claim and — if the claim is approved — issues payment to the policyholder or a verified interested party acting on the policyholder’s behalf.

Insurance Claim Forms

  1. Form CMS-1500, Health Insurance Claim Form (and Form HCFA-1500). The document was developed by the Centers for Medicare & Medicaid Services and is used by the patients with existing coverage of medical expenses. The application must be signed by a patient and a physician (or a supplier).
  2. EDD Unemployment Insurance Application. Individuals submit the correct version of Form DE 1101ID to the California Employment Development Department to file or reopen their claim for unemployment benefits.
  3. Unemployment Insurance Claim. If an individual becomes unemployed, they may file an Unemployment Claim with local authorities to receive their unemployment compensation benefits. All states have their own version of this claim form - some have are available for e-filing only.

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This form is used for submitting a wellness claim to Allstate insurance company in Florida.


This Form is used for filing a stroke claim with Cblife insurance company.

This type of document is used for reporting death claims to Gulf Guaranty Life Insurance Company.

This is an Arizona legal document needed to verify that you were unemployed during the report week and are eligible to receive Arizona Unemployment Insurance or AZUI.

This form is used for filing a claim for disaster unemployment assistance (DUA) in the state of Missouri. It provides information on how to file for DUA benefits in the event of a disaster.

This Form is used for filing a labor dispute statement by a claimant in Kansas. It is used to initiate a claim related to a labor dispute and provide relevant information about the issue at hand.

This Form is used for providing a Reasonable Assurance Statement for claimants in Kansas. It is used to establish eligibility for certain benefits or claims.

Physicians and other healthcare providers and professionals may use this legal document to submit claims for medical services. Form CMS-1500 provides information about the patient and insured, their diagnosis, treatment, and insurance details.

This Form is used for submitting health insurance claims. It is a standard form that healthcare providers use to request payment from insurance companies for the services they provide to patients.

This form is used for claimants in Iowa to provide an affidavit and grant power of attorney. It helps individuals assert their legal rights and manage their claims effectively.

This form is used for filing a continued claim for unemployment benefits in the state of New Hampshire. It allows individuals to provide updated information and certify their ongoing eligibility for benefits.

This document is used to record a claim in the state of New Jersey. It provides an official record of the details and information related to the claim.

This Form is used for filing a claimant's affidavit of federal civilian service wages and reason for separation for the Unemployment Compensation for Federal Employees (UCFE) program in North Dakota.

This form is used for filing an initial claim for unemployment benefits in the state of Oregon. It is necessary for individuals who have recently become unemployed and wish to apply for financial assistance.

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