Life Claim Package

A link to your claim package is below. 

Instructions:

  • If the death occurred outside of the United States, was a result of a homicide or occurred within two years from the date the policy was issued (or two years from reinstatement of the policy), special claim forms apply. Please contact our office for the appropriate forms.

  • If there is more than one beneficiary, each beneficiary must complete their own claim form package.

Please remember to include the following:

  • Completed Claimant’s Statement
  • Certified Death Certificate showing cause of death for the insured
  • If the beneficiary is deceased, include a copy of the beneficiary’s death certificate
  • If the beneficiary is an estate, include letters of administration, letters of testamentary, appointment as affiant or small estate affidavit
  • If the beneficiary is a trust, include a copy of the trust document pages disclosing the trust creation date, initial and successor trustee(s) and signature page
  • If the beneficiary is a minor, include certified letters of guardianship, if applicable
  • If the claim proceeds are assigned, include the original assignment form

Mail the completed Claimant’s statement and required documents to our office.  Proper completion of the Claimant’s statement and receipt of all of the required documents will expedite the handling of this claim. 

For your convenience this package is fillable and can be completed on your PC, printed and signed.  

If you have any questions, please contact us.

Our release of forms does not constitute our acceptance of liability. All claims are subject to a claim review, including verification of death, policy validity and beneficiary status. It may be necessary for us to request additional information from you or a third party to properly evaluate your claim. This could result in a delay in the processing of the claim.

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