File a Disability Claim

You can choose to file your entire claim over the phone by calling the Cornerstone Claims Department at (847) 387-3889, or you can complete the below form and schedule a time to finish the claim filing process.

1Contact Information

2Employer Information

3Claim Information

4Availability

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP
Primary Phone*
Phone Type*
Email
Date of Birth*
Month
Day
Year