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Web dental claim form header information type of transaction (mark all applicable boxes) statement of actual services request for. Web download a claim form. Filing a claim with ameritas is easy. Group claim office / p.o. Group claim office po box 82520 lincoln, ne 68501 fax: Web individual dental claim form ameritas life insurance corp. Web spanish dental claim form. On this page, you’ll be able to begin the claim process for your life insurance, disability insurance or annuity policy.