Assurant KC3136A 2006-2024 free printable template

Life/Accidental Death & Dismemberment Beneficiary Designation * Required Field Policy no. * Part no. * Account no. * Certificate no. * Group policyholder or participating employer * * Name of insured

3. Enter only the Social Security numbers and dates of coverage required by law. For most applications, only the applicant's date of birth or the number that appears on his record is sufficient. For most individuals, Social Security numbers and dates of coverage will appear above the “I” column on the first page of the Application for Benefits. 4. For the number of dependents you are giving an additional blank line and enter it.

Video instructions and help with filling out and completing wills and beneficiary forms printable

Instructions and Help about voya life insurance beneficiary form

Hi I'm Jenna I'm here to assist you in filling out the beneficiary change form from pensions and benefits USA this form is used for making changes in the selection of beneficiaries who receive proceeds from insurance plans offered by pensions and benefits these may include coverage provided for you by P and B such as the pensioners' death benefit plan the pastor's life insurance plan or additional plans in which you are enrolled this document allows P and B in our insurance underwriter Aetna to expedite the disposition of funds after your passing as insurance proceeds payments to beneficiaries from these sources bypass probate in most cases this allows proceeds to be distributed fairly quickly speaking of speeding at the process to help expedite claims we recommend you complete one beneficiary designation change form for each plan in which you are enrolled it is important to review them periodically as there are changes in your life such as marriage birth divorce death and so on before we begin here are a few guidelines that will benefit you and help us number one please type or print your responses in ink and make sure your handwriting is easily read this is a legal document, and it's important that everyone who deals with it can clearly understand your wishes number two if you make a mistake just start over with a new form they're available in fillable forms at PB USA org and are easily printed out on your own printer the use of liquid paper are marking through a mistake gives the appearance of a change and might result in your wishes being questioned you want to avoid the appearance that anyone other than you completed this form number three be sure to sign and date your form before returning it to us an unsigned undated form is not a legal document also be aware that typically the insurance company won't approve a form which is signed by a power of attorney in number four if you wish to list a will estate or trust as a beneficiary this is not the correct form for you in such case email us that help at PB USA org in preparing to complete this form here are a few things to consider before you start number one give careful thought to whom you choose to be aware there is no legally binding requirement that would compel the beneficiary of your proceeds to carry out your wishes even if you have a prior agreement with them for instance if you choose to make a friend the beneficiary with the understanding he will use the money to care for your infant children that person may choose to honor or disregard your wishes without legal consequences so be careful about whom you select number two minor children should not be listed as beneficiaries an insurance company cannot pay a benefit to a minor child doing this would result in cumbersome legal procedures that could cost time and money in most cases it's best to leave the benefits to your spouse and let him or her take care of the children number three do not list yourself it's important that you don't...

People Also Ask about wills and beneficiary forms printable

Can you change beneficiary over the phone?

How to change the beneficiary of your life insurance policy. You can change the beneficiaries of your life insurance by contacting your insurance company. You'll need to submit a change of beneficiary form online, on paper, or over the phone.

What is the phone number for Assurant extended warranty claims?

To file or check on a claim, call 1-800-626-2224.

What phone companies use Assurant?

Welcome to the Mobile Protection Center T-Mobile USA. T-Mobile Puerto Rico. T-Mobile For Business.

How do I get in contact with Assurant?

This portal gives you access to information about your plan, file a new claim or track a claim already in progress. You can also call 866.553.3239 to get started.

How do I talk to someone at Assurant?

8:00 a.m. - 8:00 p.m. ET. Claims Customer Service: Speak to a live representative to report a new claim 24 hours a day, 7 days a week by calling 1.800. 358.0600. Claims management is available Monday - Friday from 8am to 8pm ET.

For pdfFiller’s FAQs

What is assurant change of beneficiary?

Assurant change of beneficiary refers to the process of updating the designated beneficiary on an insurance policy or any other financial account offered by Assurant, a global provider of risk management solutions. A change of beneficiary allows the policyholder or account holder to name a new person or entity as the recipient of the benefits or proceeds in the event of the policyholder's death or another triggering event. This process typically involves completing a beneficiary change form provided by Assurant and submitting it to the company for processing. It is important to keep beneficiary designations up to date to ensure that the intended recipient receives the benefits.

Who is required to file assurant change of beneficiary?

The policyholder or owner of the policy is typically required to file a change of beneficiary form with their insurance provider. However, it is advisable to check with the specific insurance company or consult a legal professional for accurate information regarding the process and requirements for changing beneficiaries.

How to fill out assurant change of beneficiary?

To fill out the Assurant change of beneficiary form, follow these steps: 1. Obtain the form: Visit the Assurant website or contact their customer service to request a change of beneficiary form. You may also find it on your insurer's website or receive it by mail. 2. Read the instructions: Review the instructions provided with the form carefully. Understand the requirements, guidelines, and any specific details related to the process. 3. Personal information: Provide your personal details, such as your full legal name, address, Social Security number, and policy number. If the policyholder is deceased, include their information as well. 4. Previous beneficiary details: List the current beneficiary's full legal name, relationship to the policyholder, and contact information. Provide accurate details to ensure proper identification. 5. Updated beneficiary information: Enter the full legal name, relationship, and contact details of the new beneficiary or beneficiaries you want to designate. Include their Social Security number or taxpayer identification number if applicable. 6. Percentage or allocation: If you want to distribute the policy proceeds among multiple beneficiaries, specify the percentage or allocation for each individual or organization. Ensure the total adds up to 100%. 7. Signature and date: Sign and date the form in the appropriate sections. If you are completing the form on behalf of someone else, indicate your relationship to the policyholder and provide your own details as well. 8. Witness and notary: Depending on your state regulations or policy requirements, you might need to have the form witnessed and notarized. Arrange for witnesses and a notary public if necessary and have them sign and provide their contact information. 9. Submit the form: Make a copy of the completed form for your records. Send the original form to Assurant through the designated mailing address provided on the form. Consider sending it via certified mail to ensure its safe delivery. 10. Follow up: Contact Assurant or your insurance company after a few weeks to confirm they have processed your change of beneficiary request. Keep a record of this communication for future reference. Keep in mind that this process might vary slightly depending on the specific Assurant policy you hold. Therefore, carefully follow the guidelines and instructions provided with the form.

What is the purpose of assurant change of beneficiary?

The purpose of an Assurant change of beneficiary is to update or modify the designated beneficiary of an insurance policy or other financial account. It allows the policy owner or account holder to make changes to ensure that the intended individual or entity receives the benefits or funds in the event of their death. This change can be made to reflect any personal or financial circumstances, such as marriage, divorce, birth, adoption, or the desire to designate a new beneficiary.

What information must be reported on assurant change of beneficiary?

When making a change of beneficiary request with Assurant, the following information may need to be provided: 1. Policyholder information: Full name, date of birth, and policy number of the existing policyholder. 2. Current beneficiary information: Full name, relationship to the policyholder if applicable, and contact information (address, phone number, and email). 3. New beneficiary information: Full name, relationship to the policyholder if applicable, and contact information (address, phone number, and email). 4. Reason for the change: A brief explanation of why the change of beneficiary request is being made. 5. Signature and date: The policyholder must sign and date the change of beneficiary request form. It is important to note that this information may vary depending on the specific requirements of Assurant or the type of policy in question. It is advisable to contact Assurant directly for precise instructions on their change of beneficiary process.

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