 |
| |
|
While we have tried to make our Claims Form as simple as possible, here are some tips that might avoid confusion and delay when completing the form:
|
|
|
|
Complete one claim form per beneficiary. The one form may be used for multiple policies. Only one certified death certificate per deceased is required.
|
|
|
|
Pages 1 to 5
|
Must all be completed.
|
|
|
|
Page 1 |
- Note the Mailing & Courier addresses for you to mail your completed form and other claim requirements. These addresses are also available on Claims Overview
- Complete all of Section D, especially Trustees and Companies
|
|
|
|
Page 3 - Section H |
- If an individual is the beneficiary, provide the individual Social Security Number
- If an estate, trust, corporation etc is the beneficiary, provide the Tax Identification Number
|
|
|
|
Page 5 |
|
|
|
|
Page 6
|
|
|
|
|
Signatures
|
Provide your signature on pages 3, 5 (and 6 if it is a contestable claim).
|
|
|
If you have questions or require further information, call our Customer Service Center at
1-800-387-2747 and ask to speak with a Claims Analyst. |
|
|