Lincoln Life & Annuity Company of New York fax number

Fax destination details

Department

Disability Claims

Purpose

Submitting group disability claims (STD/LTD). The employer completes the employer's portion and returns or faxes the form to the number 877-843-3950; after that, the claimant completes the form for disability benefits and sends attachments (enrollment copies, medical evidence) as directed.

Form

GLC-01252NY CLMFRM 9/15 — Group Long-Term Disability Claim

Address

Service Office Address: PO Box 2609, Omaha, NE 68103-2609

Voice phone

Toll free (800) 423-2765

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.

Employer completes the required sections and faxes the completed employer portion to the provided fax number (877-843-3950); include enrollment copies and medical evidence if required; then give the remaining form to the claimant to complete; follow the on-form instructions for submission.

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