File Claims

At the Rookis Agency, we understand how confusing it can be to handle the forms providers often require. So if your company uses the Rookis Agency, you’re covered. Simply click on the form you need below – be it a claim or a change in your beneficiary – to download a PDF. Then call us for personal guidance in completing the form and return it to the Rookis Agency. You can drop it by the office, send by mail or fax to (205) 595-2241. We’re here to make this process easier for you. We want to review your claim form with you to help verify it is complete. We’ll even mail or fax your form from our office if you like.

Health Screenings and Doctor office visits less than a year old can be filed online at or by phone at 1-800-325-4368 


Claim Form Library


This PDF should be used to submit an accident claim. If you are also filing for disability benefits, please complete the Disability claim form.

 Continuing Disability

This PDF should be used to submit additional information for your on-going disability claim.

Health/Wellness Claim

This PDF should be used for the express filing of health or wellness screening claims that are over a year old.

Doctor’s Office Visit (Medical Bridge 3000)

This PDF should only be used to submit a claim form for a doctor’s office visit if you have a Medical Bridge 3000 policy.

 Critical Illness

This PDF should be used to submit a claim for the critical illness benefit.

Universal Claim Form

This PDF can be used to submit a claim for disability, cancer, accident, and hospital confinement.