Deceased Information

Contact Information

A Death Benefit Proceeds form will be sent to you only if you are the beneficiary or the beneficiary's authorized representative (such as an attorney or a guardian for a minor). Please provide additional details in the "Other Information" box if you are the beneficiary's authorized representative.

If you are not the beneficiary or beneficiary's representative you can still initiate a claim online. Make sure you enter the Social Security Number as 111-11-1111 and the Date of Birth as 11/11/1111 when filling out the form information. If the deceased had a policy with us, we will begin the claim process and contact the beneficiary listed on our policy records.

Funeral Home Information

Providing the information below may help expedite the processing of the claim.

Other Information