Privacy Notice
FACTS
WHAT DOES beneficiary statements for life insurance claims DO WITH YOUR
PERSONAL INFORMATION?
Why?
Wayne State University Board of Governors Life Insurance Benefits ...
Life Insurance Benefits. Beneficiary Statement Fraud Notices. Some states require us to provide the following information to you: CALIFORNIA RESIDENTS .
http://www.standard.com/eforms/1794_648846ben.pdf
What?
Life Insurance Benefits Application Instructions
Division 037. Sub 107. Code 402. 403. 404. 405. 406. 407. M. F. Transmittal Date . Authorized Signature. Life Insurance Benefits. Beneficiary Statement .
http://www.standard.com/eforms/1794.pdf
- Social Security number and income
- Account balances and payment history
- Credit history and credit scores
Phoenix Wealth Management: Life Insurance Claims
Most life insurance claims with Phoenix can be processed after we receive: Beneficiary Statement of Benefits (pdf, 30K), filled out and signed by the named .
http://www.phoenixwm.phl.com/public/customerservice/claims.jsp
How?
Beneficiary Statement
F5562-GRP-ACH 4-2008. Beneficiary Statement. Minnesota Life Insurance Company - A Securian Company. Group Division Claims • P. O. Box 64114 • St. Paul, .
http://ben.omb.delaware.gov/life/documents/beneficiary_statement_LCE.pdf
| Reasons we can share your personal information | Does beneficiary statements for life insurance claims share? | Can you limit this sharing? |
|---|---|---|
| For our everyday business purposes - such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus |
Yes | No |
| For our marketing purposes - to offer our products and services to you |
Yes | No |
| For joint marketing with other financial companies | Yes | No |
| For our affiliates' everyday business purposes - information about your transactions and experiences |
Yes | No |
| For our affiliates' everyday business purposes - information about your creditworthiness |
Yes | Yes |
| For our affiliates to market to you | Yes | Yes |
| For nonaffiliates to market to you | Yes | Yes |
To limit our sharing
Preference Beneficiary's Statement
a beneficiary or no designated beneficiary survived the insured. CLAIM NUMBER . M. Preference Beneficiary's Statement. Minnesota Life Insurance Company .
http://ben.omb.delaware.gov/life/documents/preference_bene_statement_LCE.pdf
Please note:
Life Insurance Claim Form
Group Life Insurance Claim Form (Use for employee/member and dependent death . Detach the Beneficiary Statement* and give a copy to each beneficiary.
http://www.cfbta.org/file/document/life-claim-form.pdf
Life Insurance Statement
Life Insurance Statement. OMB No. 1545-0022 . 16 Indemnity benefits. 16 $ . beneficiary, of a single-premium policy on life of insured at attained age, for .
http://www.irs.gov/pub/irs-access/f712_accessible.pdf
Questions?
Instructions for Filing a Group Life (or Dependent Life) Claim
A claim for Group Life Insurance benefits should be submitted to Assurant . Along with the Group Employer Statement and Beneficiary Statement, we will also .
http://www.assurantemployeebenefits.com/816/aebcom/forms/claims/k2176a.pdf
| Who we are | |
|---|---|
| Who is providing this notice? | Employer Instructions for Filing Group Life Insurance Claims |
| What we do | |
|---|---|
| How does beneficiary statements for life insurance claims protect my personal information? | Colonial Penn - Claims FAQs Report a Claim |
| How does beneficiary statements for life insurance claims collect my personal information? | We collect your personal information, for example, when you:
Filing a Life Insurance Claim |
| Why can't I limit all sharing? | Federal law gives you the right to limit only
Life Insurance FAQs -- Aetna |
| What happens when I limit sharing for an account I hold jointly with someone else? | AXA Equitable Life Insurance Forms |
| Definitions | |
|---|---|
| Affiliates | Life Insurance Claim Form - LifeMapCo.com
|
| Nonaffiliates | Life Insurance Benefits Application Instructions
|
| Joint marketing | UN Health and Life Insurance Section
|
Other important information
Life Insurance Claims from MetLife
Find how to make life insurance claims on MetLife.com. . At MetLife, taking care of beneficiaries — Delivering the Promise — is probably the single . A completed Statement of Claim, a form that includes such things as your full name and .
http://www.metlife.com/individual/insurance/life-insurance/claims.html
How to File a Life Insurance Claim
But for legal and tax purposes, beneficiaries must file a life insurance claim in . card and bank statements, and contact your loved one's employer or benefits .
http://www.insweb.com/life-insurance/file-claim-life-insurance.html
FG 0015 11-30-09_FG 0015 505.qxd.qxd
B. Beneficiary Information . The undersigned requests that Phoenix Life Insurance Company pay, without production of the lost . knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application .
http://www.phoenixwm.phl.com/shared/eforms/getdoc.jsp?DocId=FG11.pdf
MyTransamerica - FAQ
Policy Service and Claims FAQs . Life Insurance Premium Payment; RAP; Loans; Beneficiaries; Claims . Transamerica Financial Life Insurance Company . home signed by the beneficiaries and an itemized statement of funeral expenses.
https://afp.transamerica.com/myta/public/faq.aspx
Dear Beneficiary - SC Employee Insurance Program - State of South ...
Employer Instructions for Filing Group Life Insurance Claims. 1. . The beneficiary must complete his or her own Claimant's Statement and return it to you, along .
http://www.eip.sc.gov/publications/Life_Insurance_Claim_Form.doc?ts=-220655499
Notice to customers with credit-related insurance products
Prudential Financial Group Insurance
How to complete and submit a Group Life insurance Claim Form . Return both the Group insurance Contract Holder Statement and the Bene?ciary Statementlsl .
http://www.uswestretiree.org/Qwest%20Group%20Life%20Insurance%20Claim%20Form%20%200107.pdf
IMMEDIATE ANNUITY CLAIM FORM STATEMENT OF BENEFICIARY
IMMEDIATE ANNUITY CLAIM FORM. STATEMENT OF BENEFICIARY. Contracts Distributing Payments. STANDARD LIFE INSURANCE COMPANY OF .
http://www.standardagents.com/Form%20Storage/F-SLDC-I.pdf
Life Insurance | DAS-HRE
Qualified Life Events, Beneficiary Designation. Cost, Decrease Supplemental Life Insurance. Increasing Supplemental Life Insurance, Life Insurance Claim .
http://benefits.iowa.gov/lifeinsurance.html
Special notice for residents of California
Claims Faqs : Customer Service : Faqs : American General Life ...
Nov 9, 2011 . How do I file a death claim on a life insurance policy? . Beneficiary: The Claimant's Statement must be completed by the beneficiary; if there is .
http://www.americangeneral.com/life/life.nsf/contents/faq_claims
Special notice for residents of Vermont
Unum Life Insurance Company of America Provi
. should you use this claim form? Use this claim form to submit a Voluntary Benefits Life Insurance claim to Unum. . How to Complete the Beneficiary Statement .
http://www.ohr.gatech.edu/sites/default/files/benefits/Life_Insurance/Whole%20Life%20Claim%20Form.pdf
Special notice for residents of Texas
DEATH CLAIM FOR ASSOCIATION PLANS (AK / IL / KS / NC / NV)
ReliaStar Life Insurance Company of New York, Woodbury, NY . The Beneficiary Statement must be signed by the beneficiary if the amount payable to the .
http://ing.us/file_repository/5475/159817_0611.pdf%20
LC-7370CT Combined Life ADD With Safe Haven CT address 07/09
Your beneficiary proceeds will be kept separate from . Part II - Beneficiary Statement (needed for both Life and Accidental Death claims) . I agree that this information is subject to audit by Hartford Life Insurance Company or Hartford Life and .
http://fhdafiles.fhda.edu/downloads/benefits/HartfordGLDeathClaimApplicat.pdf
life insurance without health exam† to access a printable version of the beneficiary statements for life insurance claims Privacy Notice
Revised: May, 2011
Online Privacy Practices
Filing a Death Claim, VA Life Insurance (U.S. Department of ...
Jul 25, 2010 . Veterans Mortgage Life Insurance Claims, A payoff statement from the . If the beneficiary desires monthly payments instead of one lump sum, .
http://www.insurance.va.gov/gli/claims/death.htm
Life Insurance Claims FAQ - Genworth
Find answers to common life insurance claim questions with Genworth Financial on topics such as beneficiaries, statements, policies, claimants, and .
http://www.genworth.com/content/tools_and_forms/claims/life_insurance_claims/life_insurance_claims.html
Claims : Life and AD&D Claims
The Hartford's standard Life and AD&D insurance claim submission and approval . physician statement (when applicable – AD&D claim) beneficiary statement, .
http://www.thehartford.com/cs/Satellite?c=Page&cid=1242758982197&pagename=GBD_Sites%2FPage%2FGeneralPage
Dependent Life Insurance | Benefits | Human Resources | Los ...
Benefits » Other Insurance » Dependent Life Insurance . About Dependent Life Insurance; Eligibility; Enrollment; Coverage; Costs; Beneficiary; Additional .
http://www.lanl.gov/worklife/benefits/insurance/deplife.shtml
Order of Precedence and Designation of Beneficiary - OPM
If you assigned ownership of your life insurance by filing an Assignment, . If you assigned your life insurance, OFEGLI will pay benefits to the beneficiary(ies) . A common-disaster clause is a statement on the designation that says that a .
http://www.opm.gov/insure/life/reference/handbook/designt2.asp
Life Insurance Benefits Application Instructions
The application for life insurance benefits consists of the forms included in this . than one beneficiary, please make a copy of the front and back of the statement.
http://www.mcneilandcompany.com/downloadPDF.aspx?pdf=standard_life_proof_of_death_form-NY.pdf
CA Codes (ins:10509.930-10509.938)
If the life insurance benefits are placed in a retained asset account, the insurer shall send the beneficiary at least one statement per quarter, and a statement for .
http://www.leginfo.ca.gov/cgi-bin/displaycode?section=ins&group=10001-11000&file=10509.930-10509.938
DEATH CLAIM
40302m. Page 2 of 3 - Incomplete without all pages. Order #115446 01/13/2009. I am making claim for the life insurance proceeds as. (Beneficiary, Spouse, .
http://episdbenefits.org/get_document.php?id=244
MONY/MLOA or USFL Life Insurance Forms
Life insurance claims are paid after the Company ensures: You are the true beneficiary; The policy is current and in force; That all . Available when assigning all or part of claim proceeds to another party; Statement as to Children Form .
http://www.axa-equitable.com/customer-service/beneficiary/Forms-MONY-MLOA-USFLLI.html
Last Revised: December, 2010
ABU14214_1-10 Administrator's Guide Life Insurance
Insurance Beneficiary” section to your health . Life) as your group term life and AD&D insurance benefits carrier. . Statement of Domestic Partnership. C15388 .
https://www.blueshieldca.com/employer/documents/administrator-resources/ABU14214.pdf.pdf
BENEFICIARY DESIGNATION FORM - TSCRA Insurance
BENEFICIARY DESIGNATION FOR ALL EMPLOYEE/RETIRED EMPLOYEE LIFE . event a dependent dies, the employee is the beneficiary of their life insurance proceeds. . for insurance or statement of claim containing any materially false .
http://www.tscrainsurance.com/forms/BeneficiaryForm.pdf
