Individual Disability Insurance (IDI) Service Forms

If you purchased MyIncome Protector individual disability insurance from a New York Life agent, this is the right place to download your insurance forms. If you have New York Life disability insurance through your employer, visit New York Life Group Benefit Solutions to access your disability insurance claim forms.

My IDI Change Request Form (Name, Address, Beneficiary, etc.) – Individual Disability Insurance

My IDI Provider Specific Authorization to Release Medical Records – Individual Disability Insurance

Claimant’s Statement for Continuing Claim – Individual Disability Insurance

Physician’s Statement for New Claim – Individual Disability Insurance

Physician’s Statement for Mental Health Conditions – Individual Disability Insurance

My IDI Payment Preferences Form (Auto Withdraw / EFT) – Individual Disability Insurance

Claimant’s Statement for New Claim – Individual Disability Insurance

Claimant’s Occupational Duties Form – Individual Disability Insurance

Physician’s Statement for Continuing Claim – Individual Disability Insurance

Authorization for Assignment of Claim Payments – Individual Disability Insurance

Authorization to Release Personal Information – Individual Disability Insurance

Download the IDI Claims Fraud Warning Statement or access service forms for other New York Life products or services.

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