Annuity Claim Package

A link to your claim package is below. 

Instructions:

Complete the Claim Form

  1. This form should be completed in full detail by the named beneficiary claimant before a witness who should sign the form. If there is more than one beneficiary, each one should complete a separate form.
  2. If the beneficiary is the Estate of the Insured, this form should be completed by the Executor or Administrator of the Estate and must be submitted with the properly certified letters of administration. Where a beneficiary signature is required, it shall be understood that the individual signing is signing in his or her capacity as the Executor or Administrator of the Estate.
  3. If the beneficiary is a Trust or other entity, this form should be completed by the Trustee/Authorized Individual and Section 8 at the back of this form must be completed. Where a beneficiary signature is required, it shall be understoodthat the individual signing is signing in his or her capacity as the Trustee/Authorized Individual.
  4. If the beneficiary is a minor, this form must be completed by his or her legal appointed guardian and must be submitted with certified letters of guardianship. Where a beneficiary signature is required, it shall be understood that the individual signing is signing in his or her capacity as the Guardian of the minor beneficiary. In the event no guardian is to be appointed, contact the Company for further instructions.
  5. If a Power of Attorney (POA) is acting for the beneficiary, where beneficiary signature is required, it shall be understoodthat the individual signing is signing in his or her capacity as POA. A complete, current copy of the power of attorney document must be submitted with this form.
  6. If the beneficiary’s name has changed, a copy of a marriage certificate, divorce decree, or other legal documentationshould be submitted with the completed form.
  7. Annuity death benefit elections have tax consequences. An election cannot be changed once processed. We strongly recommend you consult your tax advisor before selecting an option below.

Enclose Certified Death Certificate – A certified death certificate with cause of death for the insured should be provided.

Enclose Contract – Unless you have elected to continue the contract as owner, the annuity contract or contracts should be
included with the claim papers.

Enclose Proof of Age – If Option 4 (Payments Over Your Lifetime) is elected, please enclose proof of age with your
completed Claim Form. Proof of age includes a copy of your birth certificate, driver’s license, passport , or other government
issued I.D.

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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