Get the free LIFE CLAIM FORM - 06-2013 - Final.doc

Combined Insurance Worksite Solutions A unit of Combined Insurance Company of America Claim Department PO Box 6700 Scranton, PA 18505-0700 Telephone 1-800-544-9382 Fax 312-351-6930 Claim Number: Beneficiary

How to fill out life claim form

How to fill out a life claim form:

1. Start by gathering all the necessary documents and information. This may include the original policy document, death certificate, personal identification documents, and any additional documentation required by the insurance company.
2. Carefully read through the life claim form and ensure that you understand all the instructions and requirements. Take note of any specific sections that need to be completed and any supporting documents that need to be attached.
3. Begin filling out the form by providing your personal information, such as your name, contact details, and policy number. Make sure to provide accurate and up-to-date information.
4. Next, provide details about the policyholder, including their name, date of birth, and policy details. If you are not the policyholder, but the beneficiary or executor, ensure that you have the necessary authority or documentation to make a claim.
5. Provide information about the deceased, including their full name, date of birth, date of death, and cause of death. Attach a certified copy of the death certificate as required.
6. If there are multiple beneficiaries, indicate their names and their respective shares in the policy. If you are the sole beneficiary, provide your details and indicate that you are the only beneficiary.
7. Complete any additional sections in the form, such as the bank account details where the claim amount should be deposited, or any specific instructions regarding the payout.
8. Review the completed form for any errors or omissions. Ensure that all sections have been accurately filled out and that the required supporting documents are attached.
9. Sign and date the form to certify its accuracy and completeness. If there are multiple beneficiaries, each one may need to sign the form.
10. Make copies of the completed form and all supporting documents for your records before submitting the original form to the insurance company. Consider sending the documents via certified mail or registered post to ensure their safe delivery.

Who needs a life claim form?

1. Policy beneficiaries who are entitled to claim the life insurance proceeds upon the death of the policyholder.
2. Executors or administrators of the deceased policyholder's estate who are responsible for handling the financial affairs and distributing the assets.
3. Anyone who has been authorized by the policyholder, such as a trusted family member or friend, to complete the claim form on their behalf.
4. In some cases, the policyholder themselves may need to complete a life claim form if they have been diagnosed with a terminal illness and are making a claim under a specific policy provision, such as accelerated death benefits.

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What is life claim form?

The life claim form is a document that is used to request a payment from an insurance company after the death of the insured individual.

Who is required to file life claim form?

Beneficiaries or legal representatives of the deceased individual are typically required to file the life claim form.

How to fill out life claim form?

The life claim form can be filled out by providing information about the deceased individual, the policy details, and the beneficiary information.

What is the purpose of life claim form?

The purpose of the life claim form is to notify the insurance company of the death of the insured individual and to request a payment under the policy.

What information must be reported on life claim form?

Information such as the policy number, date of death, cause of death, beneficiary information, and any other relevant details must be reported on the life claim form.