Get the free Life Insurance Claim Form Claimant's Statement

Get Form

Show details

Death Claim Claimants StatementWhat documents are required? Basic Life Insurance Employer\'s Statement (Form No. 12123E) Claimant\'s Statement (Form No. 02227A) Death certificate or funeral directors

We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign life insurance claim form

Edit your life insurance claim form form online

Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.

Add your legally-binding signature

Draw or type your signature, upload a signature image, or capture it with your digital camera.

Share your form instantly

Email, fax, or share your life insurance claim form form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing life insurance claim form online

Ease of Setup

pdfFiller User Ratings on G2

Ease of Use

pdfFiller User Ratings on G2

Follow the guidelines below to use a professional PDF editor:

1

Set up an account. If you are a new user, click Start Free Trial and establish a profile.

2

Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.

3

Edit life insurance claim form. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.

4

Get your file. When you find your file in the docs list, click on its name and choose how you want to save it. To get the PDF, you can save it, send an email with it, or move it to the cloud.

pdfFiller makes working with documents easier than you could ever imagine. Register for an account and see for yourself!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.

Learn more about security & compliance

How to fill out life insurance claim form

01

Gather all necessary documents such as death certificate, policy information, and identification.

02

Contact the life insurance company to request a claim form or download it from their website.

03

Fill out the form completely and accurately, providing all required information.

04

Double check the form for any errors or missing information before submitting.

05

Submit the form along with any additional required documents to the insurance company either online, by mail, or in person.

Who needs life insurance claim form?

01

Beneficiaries of a deceased policyholder who is covered by a life insurance policy need to fill out the life insurance claim form in order to receive the death benefit.

Fill form : Try Risk Free

Rate the form

4.7

Satisfied

31 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

How can I manage my life insurance claim form directly from Gmail?

You can use pdfFiller’s add-on for Gmail in order to modify, fill out, and eSign your life insurance claim form along with other documents right in your inbox. Find pdfFiller for Gmail in Google Workspace Marketplace. Use time you spend on handling your documents and eSignatures for more important things.

How can I send life insurance claim form for eSignature?

To distribute your life insurance claim form, simply send it to others and receive the eSigned document back instantly. Post or email a PDF that you've notarized online. Doing so requires never leaving your account.

Can I edit life insurance claim form on an Android device?

You can. With the pdfFiller Android app, you can edit, sign, and distribute life insurance claim form from anywhere with an internet connection. Take use of the app's mobile capabilities.

What is life insurance claim form?

Life insurance claim form is a document that the beneficiary of a life insurance policy needs to fill out and submit to the insurance company in order to receive the death benefit.

Who is required to file life insurance claim form?

The beneficiary or the designated individual who is entitled to receive the death benefit from a life insurance policy is required to file the life insurance claim form.

How to fill out life insurance claim form?

To fill out a life insurance claim form, the beneficiary needs to provide basic information such as policy details, cause of death, beneficiary information, and any additional required documents.

What is the purpose of life insurance claim form?

The purpose of a life insurance claim form is to notify the insurance company of the insured individual's death and request the payment of the death benefit to the designated beneficiary.

What information must be reported on life insurance claim form?

The information that must be reported on a life insurance claim form includes policy details, cause of death, beneficiary information, and any other relevant information requested by the insurance company.

Fill out your life insurance claim form online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now