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Life insurance claim forms

How to make a claim

If you have coverage through your employer or plan sponsor, use this form if you are a beneficiary or estate representative making a life insurance claim. 

To make a claim:

Step 1: Complete a claim form.

Download the statement and print it or fill it out in Adobe Reader XI or higher - Opens in a new window (not your browser) and save.

Step 2: If applicable, request a certificate of death from the attending physician.

In some cases, you will need to ask the attending physician for a certificate of death. Download this form, and ask them to fill it out.

Step 3: Submit your claim.

Once you’ve filled out and completed the applicable forms, send them to us at

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I have coverage through my employer

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