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IMPORTANT Complete and return this form to our Administrator at Combined Insurance/Combined Assurances P. STATEMENT OF LOST POLICY PLATINUM TERM 10 TO AGE 85 REQUEST FOR NAME CHANGE Owner Name Address This is in reply to your recent request for a Name Change under your Platinum Term Life Insurance Policy underwritten by Chubb Life Insurance Company of Canada Chubb Life /Chubb du Canada Compagnie d Assurance-Vie Chubb-Vie. O. Box 3720 MIP Markham Ontario L3R 0X5 Fax 905-305-8600. POLICY...
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How to fill out statement of lost policy

01
Gather all necessary information about the lost policy, including policy number, policyholder's name, and the insurance company's contact details.
02
Create a cover letter addressed to the insurance company explaining the situation and requesting a statement of lost policy.
03
Include a copy of any documents related to the policy, such as previous correspondence or proof of ownership.
04
Clearly state the reason for requesting the statement of lost policy, providing any relevant details or incidents that led to the loss.
05
Provide your contact information, including name, address, phone number, and email, so the insurance company can reach you if needed.
06
Prepare the package containing the cover letter and supporting documents, ensuring everything is securely sealed.
07
Send the package via certified mail or a traceable shipping method to ensure it reaches the insurance company safely.
08
After receiving the statement of lost policy, review the document carefully for accuracy and verify that all necessary information is included.
09
Keep a copy of the statement of lost policy in a safe place for future reference.

Who needs statement of lost policy?

01
Anyone who has lost their insurance policy should obtain a statement of lost policy.
02
Policyholders who require a replacement policy due to loss or damage of the original document will need a statement of lost policy.
03
Individuals who need to provide proof of the lost policy for legal or administrative purposes may also need a statement of lost policy.
04
Insurance agents or brokers who handle policyholder claims related to lost policies may need to gather statements of lost policy for their clients.
05
Any person or organization dealing with an insurance company regarding a lost policy should consider obtaining a statement of lost policy.
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Statement of lost policy is a form submitted by an insurance policyholder to report the loss of their original insurance policy document.
Insurance policyholders who have lost their original insurance policy document are required to file a statement of lost policy.
Statement of lost policy can be filled out by providing personal information, policy details, and the circumstances of the loss.
The purpose of statement of lost policy is to inform the insurance company about the loss of the original policy document and request a duplicate copy.
Information such as policyholder's name, policy number, insurance company name, date of loss, and a statement describing the circumstances of the loss must be reported on statement of lost policy.
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