Capital Insurance Agency

Our Team is Standing By to Help You Get the Form You Need

Find the Right Form

If you can’t find the form you need, our knowledgable insurance specialists are here to help. Simply fill out the fields below, and we will be in contact with you within one business day to direct you to the correct form, plus offer further assistance if you have any questions.

First Name *

Last Name *

Personal Email *

Cell Phone *

Best Time/Day to Contact You

Work County *

Please choose the form you are trying to find from the options below: *

Aflac Cancer Claim Form - Pre-Tax Benefit Code 0102

Aflac Cancer Wellness Claim Form - Pre-Tax Benefit Code 0102

Cigna Hospital Supplement Claim Form - Pre-Tax Benefit Code 0101

LINA Disability Claim Form - Deduction Code 0300 Capital DI underwritten by LINA

LINA Group Term Life Claim Form - Deduction Code 0262

Other (Please use the space below to let us know what form you need.)

Additional Comments or Questions