Claim Forms
- Report a Death Claim (Online Form)
- Acknowledgement of Misplaced Policy
- Beneficiary Claimant Statement
- Beneficiary Claimant Statement - Under $5,000
- Gold Cross Burial Association Claim Form
- Premium Waiver Form
Other Forms
- Duplicate Policy Request Form
- Affidavit of Lost Policy - International Life Policies
- Annuity Cash Value and Maturity Value Request
- Bank Draft Authorization Form (In English) / (en Español)
- Beneficiary Change Form
- Cash Surrender or Partial Withdrawal Form
- Certificate of Trust Agreement
- Collateral Assignment
- Collateral Release
- Credit Card Authorization
- HIPAA Form (release PHI from provider) / Other HIPAA Form (release PHI to agent, family member, other 3rd party)
- Loan Agreement - Tax Deferred Annuity
- Mortgage Company Release Authorization
- One and the Same Name Affidavit
- Ownership Change Form
- Policy Service Form
EASY UPLOAD MOBILE APP
The Easy Upload mobile app or the Form Upload tool found on the Client Services site can be used to securely send documents to us regarding a specific Life & Health policy or Annuity contract, even if you aren’t a registered contract/policy holder. Simply click on the Start Uploading button. You will need to know the contract/policy number and the owner’s zip code to use this feature.
