American Fidelity Assurance Co.
Fax: (800) 818-3453
Please provide a doctors note to Human Resources with the dates that you will be off of work and complete your section of the disability form. Human Resources will complete the Employer's Report of Claim section of the form.
We will send the documentation directly to American Fidelity ONLY if your portion is completed prior to turning it in to Human Resources.
**REMINDER: YOU WILL NEED A DOCTORS NOTE RELEASING YOU (WITH ANY MODIFICATIONS) BEFORE YOU CAN RETURN TO WORK.**