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Life Insurance

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Claim Forms

The Options listed in the brochures below may not be available to all beneficiaries. If you have questions on your available options, please call us toll-free at 800-733-2524. We are available Monday through Thursday from 7:30 am to 5:00 pm, CST and Friday from 7:30 am to 12:30 pm.

Claims FAQs

Frequently Used Claim Forms

Beneficiary Information and Instructions (O-2816-2)

Claimant Statement (O-2818-1)

Claimant Statement Part II (O-2818-2)

Certification of Trust Agreement (L-3172A)

Certification of Power of Attorney (O-2876)

Affidavit of Surviving Children (O-2794)

Authorization for Release of Information for Claims Administration (HIPPA) (O-2722)

Foreign Death Questionnaire (O-2796)

Generation Skipping Transfer (O-2797)

Contestable Claim Forms

Claimant Statement (Contestable) (O-2818-1C)

Claimant Statement Part II (Contestable) (O-2818-2C)

Authorization for Release of Information for Claims Administration (HIPPA)-Contestable (O-2722C)

Writing Agent Statement for Routine Contestable Claim Investigation

Claim Brochures

A Guide for Beneficiaries (O-2789)

Access Account (O-2692)