Life insurance waiver due to disability
How to make a claim
Use this form to apply for a waiver of life insurance premiums due to disability.
To submit a claim:
- Print the appropriate form, and complete Part 1.
- Have your doctor (or your child’s doctor) fill out Part 2.
- When both parts are completed, please send a scanned copy to us via email at firstname.lastname@example.orgOpens in a new window or by fax at 2 0 4 % 2 0 9 4 6 4 0 3 0.
In light of COVID-19, we ask that you do not mail these forms to us.