How do I submit a disability claim?

Your disability plan helps protect your income in the event of a disabling illness or injury. If you become disabled, please follow the instructions below on filing a claim with Mutual of Omaha.

Required Information

To process your claim timely, please download the form attached to this article and ensure that all three sections of the claim submission must be completed and signed:

1. Section 1: You will need to complete the Employee statement, including authorizations to release your information
2. Section 2: The the STG Family of Companies human resources department will need to complete the Employer’s statement
3. Section 4: You will be responsible for having your doctor complete the Attending Physician’s Statement

Filing Options

Fax/Paper

1. Download the form attached to this article
2. Complete your section, have the the STG Family of Companies human resources department and physician complete their sections, and sign. 
3. Fax pages to Mutual of Omaha at 402-997-1865. Or, scan the completed and signed forms and email them to: [e-mail]

Online

1. Download the form attached to this article
2. Please complete the online form by providing all the information. Mutual of Omaha only accepts Section 1 (Employee Statement) online.
3. Provide your physician’s contact information (phone, fax, address) in the required field.
4. Select “Submit.”
5. Print page 8 of the attached titled “Authorization to Disclose Personal and Health Information” form. Complete, sign, and fax to 402-997-1865. Or, scan the completed and signed forms and email them to: [e-mail]

Phone

1. Call 1-800-877-5176 to start the claims process.
2. A customer service representative will complete Section 1 (Employee Statement) with you. 
3. Provide your physician’s contact information (phone, fax, address).
4. After the call, please print page 5 and 6 of the attached titled “Authorization to Disclose Personal and Health Information complete, sign and fax it to 402-997-1865. Or, scan the completed and signed forms and email them to: [e-mail]

Mail

Once you have completed the attached paperwork, you can also mail them to:

Mutual of Omaha Insurance Company

Group Insurance Claims

3300 Mutual of Omaha Plaza Omaha

NE 68175-0001

Checking your Claim Status

Once you've submitted your claim, the Mutual of Omaha Employee Portal allows you to view current claims.

You can also call the Mutual of Omaha dedicated toll-free number: [phone] (Monday – Friday, 7:30 a.m. – 5 p.m. CST).

• Moo_-_Disability_Claim_Form_-_0327.pdf400 KB