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Likewise, Assurance Company P.O. Box 2272 Seattle, WA 98111-2272 425-918-4575 Application for Accelerated Benefits (TO AVOID DELAY, PLEASE ANSWER ALL QUESTIONS) PLEASE PRINT EMPLOYEE 1. FULL NAME

How to fill out application for accelerated benefits

How to fill out application for accelerated benefits?

1. Gather necessary documents: Before filling out the application for accelerated benefits, gather all the necessary documents such as proof of income, medical records, and any other supporting documents required by your insurance provider.
2. Review the eligibility criteria: Check the eligibility criteria for accelerated benefits to ensure you meet the requirements. This could include being diagnosed with a terminal illness or facing a life-threatening condition.
3. Fill out personal information: Start by filling out your personal information accurately. This may include your name, address, contact details, social security number, and other identifying information.
4. Provide medical information: Provide detailed medical information, including the name of your healthcare provider, diagnosis, treatment plan, and any other relevant details. It is important to be thorough and accurate in this section.
5. Submit supporting documentation: Attach all the required supporting documentation along with the application form. This may include medical records, doctor's recommendations, and any other documents that support your application.
6. Review and double-check: Carefully review the completed application form and all the attached documents. Make sure all the information provided is accurate and complete. Double-check for any errors or missing information.
7. Submit the application: Once you are satisfied that the application is complete, submit it according to the instructions provided by your insurance provider. This may involve mailing the application or submitting it online through a secure portal.

Who needs application for accelerated benefits?

1. Individuals with terminal illnesses: Accelerated benefits are typically designed for individuals diagnosed with a terminal illness. These benefits provide financial assistance during the advanced stages of the illness.
2. Life insurance policyholders: Many life insurance policies offer accelerated benefits as a rider or additional option. Policyholders who meet the eligibility criteria may choose to apply for accelerated benefits to receive a portion of their life insurance policy's death benefit before passing away.
3. Those facing life-threatening conditions: In some cases, insurance providers extend accelerated benefits to individuals facing life-threatening conditions other than terminal illnesses. These conditions could include critical illnesses or severe disabilities that significantly impact the individual's life expectancy.

For pdfFiller’s FAQs

What is application for accelerated benefits?

Accelerated benefits are a provision in an insurance policy that allows the policyholder to receive a portion of their death benefit while they are still alive.

Who is required to file application for accelerated benefits?

The policyholder or the designated beneficiary may be required to file the application for accelerated benefits, depending on the terms of the insurance policy.

How to fill out application for accelerated benefits?

To fill out an application for accelerated benefits, you will need to provide information about the policyholder, medical information, and details about the requested benefit amount.

What is the purpose of application for accelerated benefits?

The purpose of the application for accelerated benefits is to request an advance on the death benefit of the insurance policy due to a qualifying event, such as a terminal illness.

What information must be reported on application for accelerated benefits?

The application for accelerated benefits may require information such as medical records, diagnosis from a healthcare provider, financial information, and the desired benefit amount.

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