Get the free Life Claim Statement - Assurant Employee Benefits

Instructions for Filing a Group Life (or Dependent Life) Claim To the Administrator: A claim for Group Life Insurance benefits should be submitted to Assurance Employee Benefits as soon as notice

How to fill out life claim statement

How to fill out a life claim statement?

1. Gather all necessary documents such as the original policy or contract, death certificate, identification documents, and any relevant medical records.
2. Contact the insurance company to inform them about the policyholder's death and to request the life claim statement form.
3. Carefully read and understand the instructions provided on the life claim statement form, ensuring that all required sections are completed accurately.
4. Provide personal information about the deceased policyholder, including their full name, date of birth, and social security number.
5. Fill in details about the policy, such as the policy number, date of issue, and any other relevant information as requested.
6. Clearly explain the cause of death, providing any available medical information or reports.
7. Disclose any additional life insurance policies the deceased may have had with other companies.
8. Include the full contact information of the beneficiary, including their name, address, and phone number.
9. If multiple beneficiaries are entitled to a share of the claim, indicate their respective shares and provide their contact information.
10. Sign and date the life claim statement form, ensuring that all information provided is accurate and true.

Who needs a life claim statement?

1. The beneficiary or beneficiaries named in the life insurance policy.
2. In case of multiple beneficiaries, each person entitled to a share of the claim requires a separate life claim statement.
3. The life claim statement acts as a formal request to the insurance company to release the death benefit to the beneficiaries or their authorized representatives.

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What is life claim statement?

A life claim statement is a document that individuals are required to complete in order to make a claim on a life insurance policy after the insured person has passed away.

Who is required to file life claim statement?

The beneficiary or the legal representative of the insured person's estate is usually required to file the life claim statement.

How to fill out life claim statement?

To fill out a life claim statement, you will typically need to provide information such as the policyholder's name, policy number, cause of death, and any supporting documentation requested by the insurance company.

What is the purpose of life claim statement?

The purpose of a life claim statement is to initiate the process of claiming the benefits from a life insurance policy after the death of the insured person.

What information must be reported on life claim statement?

The information that must be reported on a life claim statement includes details about the policyholder and the policy, as well as any supporting documentation or proof of death.