Supplemental Life Insurance

To apply for Colonial life insurance, please contact a representative to enroll in person. Some policies that may be elected are:

• Accident
• Term Life
• Critical Illness
• Short-Term Disability Buy-Up
• Cancer Insurance
• Hospital Confinement
• Whole Life Insurance

For any changes, cancellations or other services, please fill out the form below and submit to address/fax indicated on top of form. Colonial Request for Service Form (PDF)