TDI Claim Submission – Alternate Submission Methods

For your convenience, Pacific Guardian Life offers several options for submitting your TDI Claim Form:

1. Use our simple online form.
2. Upload your form via our Encyro Secure Messaging Service.
   • Download the applicable TDI Claim Form below and fill it out. Once completed, upload your form using the Encyro Secure Messaging Service.
   • Important: Forms must bear an original signature (print, sign, and scan your form) or a certified digital signature.
3. Email your form to [email protected]
4. Fax your form to (808) 942-1284.
5. Mail in your form to:
   • Pacific Guardian Tower
   • 1440 Kapiolani Boulevard, Suite 1700
   • Honolulu, HI 96814-3698

Experience our quickest processing times by using Submission Method 1 or 2.

Download the TDI Claim Form

• For Claimants
• For Employers
• For Physicians

Additional Information

Information on Claims Administration

Contact Pacific Guardian Life for assistance