Guardian Life Insurance Company of America fax number

Fax destination details

Department

State Disability Claims

Purpose

Disability benefits claim submission for New York State Disability Benefits using Form DB-450 (Notice and Proof of Claim for Disability Benefits) via Guardian Life State Disability Claims.

Form

DB-450 — Notice and Proof of Claim for Disability Benefits

Address

Guardian State Disability Claims, PO Box 14332, Lexington, KY 40512

Voice phone

1-800-268-2525

Website

Visit organization website

Before you send

• Confirm that this exact department handles your document or request.
• Check the organization website or call its main line for the current fax number.
• Include a cover sheet and any case, member, claim, or form reference required.
• Keep the delivery confirmation with your submission records.

Submit within 30 days of the first day of disability. Complete Part A (employee information); have healthcare provider complete Part B and the employer complete Part C; return to Guardian State Disability Claims or as instructed by the carrier. This form is used to apply for New York State Disability Benefits; see the DB-450 instructions for detailed steps and required documentation.

Official form instructions are published as a downloadable file on the organization's website.