Individual Life Claim 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. 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. PLEASE REMEMBER TO INCLUDE THE FOLLOWING Completed Claimant’s Statement Certified Death Certificate showing insured’s cause of death 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 Life Claim Package For your convenience this package is fillable and can be downloaded to your PC, then completed, printed, and signed. DOWNLOAD 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. Looking for assistance with a claim? Contact Us