Thank you for contacting Mutual of Omaha to request your My Health, My Data Act rights.

To adequately respond to your request, and to prevent fraudulent requests, please provide the information below. For your protection, please do not provide any identifiers beyond what is requested below. Any reference to “Mutual of Omaha” in this webform includes Mutual of Omaha Insurance and its affiliated companies.

Are you making this request:

NOTE: If you are making this request on behalf of another consumer, you must be an "authorized agent" of that person. To be an "authorized agent", you must be a natural person or business entity that the consumer has authorized to act on their behalf. To demonstrate you are an authorized agent, we require you and/or the consumer to provide documentation that the consumer gave you written permission to submit this request on their behalf.

Please submit documentation that you are an authorized agent to: Once documentation is received, we will review your request.

Please choose an option
Please answer the remaining questions in this webform using the information of the consumer on whose behalf you are submitting this request.
Please agree to proceed
Please enter a first name.
Please enter a last name.
Please enter your street address.
Please enter a city.
Please select your state. Please select a U.S. state from the dropdown menu.
Please enter a ZIP code.
Please enter a valid phone number.
Please enter a valid E-mail when choosing electronic response.
Are you a current or former customer/applicant of Mutual of Omaha Insurance or an affiliated company product?
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Which of the following consumer rights would you like to exercise:
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How would you like to receive the response to your request(s)?
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Please check the box to confirm this information is accurate.