Group Policy

To proceed with your claim, we will need you to provide some important documents.

Please make sure to include the following:

• Benefits Request completed and signed by the claimant and policyholder

For accident-related medical expenses:

• Receipts for medical expenses and medical evidence.

In the case of natural death:

• Death certificate (RD-77 Model)
• Funeral expenses invoice

‍In the case of accidental death:

• Death certificate (RD-77 Model)
• Police report
• Autopsy report
• Funeral expenses invoice

‍In the case of accidental loss of vision or dismemberment:

• Medical records

You can submit these documents using any of the following methods:

• Email: servicio.reclamaciones@cosvi.com (only PDF format documents will be accepted)
• Postal mail: P.O. Box 366267 San Juan, PR 00936-6267
• Fax: 787-200-2574
• Physical delivery: Feel free to visit any of our offices to deliver the documents in person.

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To proceed with your claim, we will need you to provide some important documents.

Please make sure to include the following:

• Completed initial claim form.
• Claim request signed by the insured and policyholder.

In case of disability:

• Benefits application completed and signed by the insured, employer, and physician

In case of continued disability:

• Claim request for continued benefits

‍In case of accidental death:

• Benefits Request Completed and Signed by Claimant and Employer
• ‍Death certificate (RD-77 Model)
• Police report
• Autopsy report
• Birth certificate for dependents under 21 years old

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You can submit these documents using any of the following methods:

• Email: servicio.reclamaciones@cosvi.com (only PDF format documents will be accepted)
• Postal mail: P.O. Box 366267 San Juan, PR 00936-6267
• Fax: 787-200-2574
• Physical delivery: Feel free to visit any of our offices to submit the documents in person.

‍

To proceed with your claim, we will need you to provide some important documents. Please make sure to include the following:

1. Benefits application completed and signed by the insured, employer, and physician
2. Medical record

You can submit these documents using any of the following methods:

• Email: servicio.reclamaciones@cosvi.com (only PDF format documents will be accepted)
• Mailing address: P.O. Box 366267 San Juan, PR 00936-6267
• Fax: 787-200-2574
• Physical delivery: Feel free to visit any of our offices to submit the documents in person.

To proceed with your claim, we will need you to provide some important documents. Please make sure to include the following:

In case of disability:

• Benefits request completed and signed by the insured, employer, and physician

In case of loss of vision or dismemberment:

• Medical Certificate
• Medical Records

In case of death:

• Benefits application completed and signed by the claimant and employer
• Death Certificate (RD-77 Model)
• Birth Certificate
• Birth Certificate of beneficiaries under 21 years of age
• Funeral expenses invoice and payment receipt

In case of accidental death:

• Police Report
• Autopsy Protocol

‍

You can send these documents using any of the following methods:

• Email: servicio.reclamaciones@cosvi.com (only PDF format documents will be accepted).
• Postal Mail: P.O. Box 366267 San Juan, PR 00936-6267
• Fax: 787-200-2574
• Physical Delivery: Feel free to visit any of our offices to submit the documents in person.

‍

To proceed with your claim, we will need you to provide some important documents.

Please make sure to include the following:

In case of loss of vision or dismemberment, please include:

• Benefits application completed and signed by the insured, employer, and physician
• Medical certificate
• Medical record

In case of disability:

• ‍‍ Benefits application completed and signed by the insured, employer, and physician

In the event of death, please include:

• Benefits application completed and signed by the claimant and employer.
• Death certificate (Model RD-77)
• Birth certificate
• Marriage certificate or cohabitation affidavit
• Birth certificates of dependents
• Study certificate for children over 21 years old
• Funeral expenses invoice and payment receipt

For accidental death, please include:

• Police report
• Autopsy report

‍

You can submit these documents using any of the following methods:

• Postal mail: P.O. Box 366267 San Juan, PR 00936-6267
• Physical delivery: Feel free to visit any of our offices to submit the documents in person.

To proceed with your claim, we will need you to provide some important documents. Please make sure to include the following:

In all cases:

• Birth certificate
• Death certificate (RD-77 Model)

In case of accidental death and dismemberment:

• Police report
• Autopsy report

In case of waiver of premium:

• Medical evidence

‍

You can submit these documents using any of the following methods:

• Email: servicio.reclamaciones@cosvi.com (only PDF format documents will be accepted)
• Mailing address: P.O. Box 366267 San Juan, PR 00936-6267
• Fax: 787-200-2574
• Physical delivery: Feel free to visit any of our offices to submit the documents in person.

‍

To proceed with your claim, we will need you to provide some important documents. Please make sure to include the following:

• Signed request form by the claimant and policyholder
• Birth certificate
• Death certificate (RD-77 Model)
• Certification of the account balance as of the date of death

‍

You can send these documents using any of the following methods:

• Email: servicio.reclamaciones@cosvi.com (only PDF format documents will be accepted)
• Mailing address: P.O. Box 366267 San Juan, PR 00936-6267
• Fax: 787-200-2574
• Physical delivery: Feel free to visit any of our offices to submit the documents in person.

‍

Para proceder con su reclamación, necesitaremos que nos proporcione algunos documentos importantes.

Por favor, asegúrese de incluir los siguientes documentos:

En caso de fallecimiento:

• Solicitud de beneficios completada y firmada por el reclamante
• Certificado de nacimiento
• Certificado de defunción (Modelo RD-77)
• Informe de la policía
• Protocolo de autopsia‍

En caso de incapacidad:

1. Solicitud de beneficios completada y firmada por el asegurado
2. Certificado de nacimiento
3. Certificado médico
4. Evidencia médica

Puede enviar estos documentos utilizando cualquiera de los siguientes métodos:

• Correo electrónico: servicio.reclamaciones@cosvi.com (se aceptarán documentos solamente en formato PDF)
• Correo postal: P.O. Box 366267 San Juan, PR 00936-6267
• Fax: 787-200-2574
• Entrega física: Siéntase libre de acercarse a cualquiera de nuestras oficinas para entregar los documentos personalmente.

‍

Para proceder con su reclamación, necesitaremos que nos proporcione algunos documentos importantes.

Por favor, asegúrese de incluir los siguientes documentos:

1. Solicitud de beneficios completada y firmada por el reclamante
2. Recibo de gastos fúnebre
3. Certificado de nacimiento del fallecido
4. Certificado de defunción (Modelo RD-77)

Puede enviar estos documentos utilizando cualquiera de los siguientes métodos:

1. Correo electrónico: servicio.reclamaciones@cosvi.com (se aceptarán documentos solamente en formato PDF)
2. Correo postal: P.O. Box 366267 San Juan, PR 00936-6267
3. Fax: 787-200-2574
4. Entrega física: Siéntase libre de acercarse a cualquiera de nuestras oficinas para entregar los documentos personalmente.

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