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Fidelity Security Life Insurance Company Proof of Death Form 2024-2026 free printable template

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PROOF OF DEATH FORMClear FormPRINT MAIL TO: Administrative Office PO Box 25326 Overland Park, KS 662255326CHECK LIST 1. 2. 3. 4.Form must be completed by the Claimant. Attach the Certified Death Certificate.
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The purpose of the statement of claim is to inform the insurance company that a covered loss has occurred and that the policyholder is seeking reimbursement.
Documents Required for Claim Process Duly filled in and signed claim form. Original policy certificate. Death certificate issued by the local authority. FIR. Post-mortem reports. Hospital discharge summary. KYC documents (like a copy of photo ID and address proof) of a beneficiary. Copy of cancelled cheque and bank statement.
Add your name and address, and the cause of your loss. For example, you can write “fire” or “car accident.” Complete the time of origin area of the document. List the monetary damages you are claiming.
In order to file a claim for the proceeds of a life insurance policy, a certified copy of the insured's death certificate is required. A death certificate is a necessary document that serves as proof of death. It may be obtained through the funeral home or the vital records department.
A Certified Death Certificate for the insured indicating cause or manner of death. The Obituary or Newspaper Article concerning the death, when available. The original contract, if available.
In most cases, the Proof of Loss must include the following: Amount of loss that the policyholder is claiming. Documentation that supports the amount of claimed loss. Date that the loss occurred.
A claimant is the person or entity claiming the death benefit under a policy. Each beneficiary must complete a separate Claimant's Statement.
As you go through your loved one's affairs, keep an eye out for proof of a life insurance policy in their personal and financial records. You might look for a copy of the policy, a document that identifies the insurer, or even a bank statement that shows proof of payment to a life insurance company.

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