Homepage Fill Out Your Life Insurance Death Claim Form
Article Structure

When dealing with the passing of a loved one, understanding the Life Insurance Death Claim form can play a crucial role in securing financial benefits. This form is used to claim the proceeds from life insurance policies, which can significantly impact the deceased's estate. It is essential to first identify any existing insurance policies by searching through documents like premium notices, checking accounts, and even correspondence. Even if a policy seems lapsed, it might still offer some benefits due to various conditions outlined in the policy. Locating insurance agents who may have worked with the deceased can provide leads as well. Once you gather the necessary information, you will typically need to complete a statement of claims and provide a death certificate. The person claiming the benefits must demonstrate their legal right to the proceeds and may need to submit additional documentation related to the deceased’s estate. In cases where beneficiaries cannot be found, there are resources to help determine if the insurance proceeds have reverted to the state. Additionally, this form comes into play alongside potential claims for Social Security or veteran’s benefits, enhancing the support available to those navigating the aftermath of a loss. Filling out this form correctly ensures that loved ones can access vital funds during a challenging time.

Life Insurance Death Claim Example

Life Insurance and Other Death Benefits

Life insurance death benefits may represent a significant portion of the deceased’s estate. It is important to identify what insurance policies may exist and to notify the insurance companies of the death.

Locating Insurance Policies and Coverage

Locate and safeguard all life insurance policies or any other indications of life insurance policies such as premium notices. Do not discard any documents that look official, especially insurance policies which appear to have lapsed. Even if a policy owner had ceased paying premiums, a life insurance policy may have been kept in force by some arrangements stated in the policy.

Often the best and quickest way to locate life insurance policies is to check the deceased’s checking accounts, credit card statements, payroll records, debt records, receipts, and correspondence. Also, if an accident was involved, check auto and homeowner insurance policies. Remember that some credit card companies and travel agencies provide accidental death coverage if their services were used for travel arrangements. Determine how travel arrangements were made and paid, and check airline ticket folders and luggage for insurance policies.

Contact friends, neighbors and relatives of the deceased for any information they may have about life insurance policies. Find out the names of life insurance agents or brokers that may have had dealings with the deceased and contact them. Ask these agents or brokers for names of other agents or brokers whom they feel may have had dealings with the deceased. It is common to have more than one agent or broker. Locate the attorneys, accountants and bookkeepers who have prepared legal,

-31-

accounting or tax work and ask them if they are aware of any policies, agents or brokers with whom the deceased may have worked.

Review those policies which you have located to determine prior policies the deceased may have owned. In the back of most life insurance policies is a copy of the original application. The application normally asks for the names of companies, amounts of coverage and when or if prior life insurances were applied for. This may help you locate older policies and prior insurance agents.

If you suspect that the name of an insurance company may have changed, contact the Washington State insurance Commissioner’s Office. They will have the new company’s name and address.

If you still feel there is a life insurance policy or other benefits outstanding, send a stamped, self-addressed envelope and your request to:

Missing Policy Service

American Council of Life Insurance

1001 Pennsylvania Avenue NW

Washington, D.C. 20004-2499

You will receive, at no charge, a lost policy tracer to fill out and return (phone requests will not be requested). The Missing Policy Service then sends copies of your lost policy tracer form to about 100 of the largest life insurance companies for them to search their records for the name of the deceased. This process will take three to six months, or longer.

If the insurance company finds that the deceased has a policy in force with them, that insurance company will then contact you directly. The American Council on Life Insurance does not do any searching of its own, nor does it notify you of any results – good or bad. They do provide you with a very valuable service by distributing your inquiry to the companies that write about 70% of all insurance policies sold.

-32-

Another important source of information is the Medical Information Bureau, which provides a service for life insurance companies. However, this form can only provide you with the names of insurance companies to which the deceased applied for a policy, not whether a policy was actually issued. After you are provided the names of the companies, it is up to you to contact them regarding what actions they may have taken regarding an individual applicant. You should also be aware that only 10 to 15 percent of life insurance applications are reported to the Medical Information Bureau, and its records only go back seven years. The Bureau also has an “activity index” which lists the insurance companies that inquired about a particular individual, which is kept for the last two years.

To use the Medical Information Bureau’s free service, write to:

Information Office, Medical Information Bureau

P.O. Box 105, Essex Station

Boston, MA 02112

In order to help you, the Bureau must have: (1) a detailed identification of the deceased, including full name, date of birth and place of birth, (2) a copy of the death certificate, and (3) either the personal representative’s court issued Certificate of Qualification or, if there is no personal representative, a letter from an attorney stating that you are an appropriate person to handle such matters and that the deceased’s estate is not subject to probate.

If the life insurance proceeds may have been paid to the State of Washington because named beneficiaries could not be located, you should contact:

The Washington State Department of Revenue

Miscellaneous Tax/Unclaimed Property/Escheats

P.O. Box 47470

1101 South Eastside Street

Olympia, WA 98504

-33-

To date no policyholder in the State of Washington has lost money due to an insolvency of an insurance company licensed to do business in the State. However, in the past few years there have been some companies deemed to be insolvent. If you have a concern regarding the solvency of a company, contact the Washington State Insurance Commissioner’s office.

Filing a Claim

Normally, insurance companies require two forms to establish proof of a claim: (1) a statement of claims and (2) a death certificate or attending physician’s statement. A company, however, reserves the right to request further information or proof if deemed necessary.

The claimant’s certificate must be completed by the person legally entitled to receive the proceeds. This person must state in what capacity he or she makes claim: named beneficiary, assignee, executer, administrator, guardian or trustee.

If the beneficiary is incompetent or a minor, a guardian should file the form. If proceeds are to be paid to an estate, an administrator or executor should complete the form. In each case, a certificate of appointment must be furnished.

If the named beneficiary is deceased, his or her death certificate must be provided as additional proof.

Social Security

The deceased is considered to be covered by Social Security if he or she paid in to the Social Security for at least 40 quarters. Check with your local Social Security office or call 1-800-772-1213 to determine if the deceased was eligible. If the deceased was eligible, there are two types of possible benefits.

A death benefit of $255 (in 1994) is provided toward burial expenses. You can complete the necessary form at your local Social Security office,

-34-

or you can ask the funeral director to complete the application and apply the payment directly to the funeral bill. This payment is made only to eligible spouses or to a child entitled to survivor’s benefits.

Survivor’s benefits for a spouse or children are as follows:

If the spouse is age 60 or older, he or she will be eligible for benefits. The amount of the benefit received prior to age 65 will be less than the benefit due at or after age 65.

Disabled widows age 50 or older will be eligible for benefits.

The spouse of the deceased who is under 60 but who cares for dependent children under 16 or cares for disabled children may be eligible for benefits.

The children of the deceased who are under age 18 or who are disabled may also be entitled to benefits.

When applying for Social Security benefits, you should have birth and death certificates of the deceased, marriage certificate, birth certificates of any dependent children, Social Security numbers, and copies of the deceased’s most recent federal income tax return.

Please remember that Social Security benefits are not automatic; they must be applied for. Delay in applying can cause loss of the some benefits because back payments cannot be made for periods exceeding 12 months.

Veteran’s Benefits

If the deceased was a veteran, the survivor may be eligible to receive a lump-sum payment of $300 (in 1994) for burial expenses and an allowance of $150 (in 1994) toward a plot in a private cemetery (burial in a national cemetery is free to a veteran, his or her spouse, and dependent children). Veterans are also eligible to receive a headstone or grave marker at no charge.

-35-

The funeral director often can help you apply for these benefits, or you can contact the regional Department of Veterans’ Affairs (VA) office. The regional office is located at 915 Second Avenue, Seattle, WA 98174 and can be contacted at (206) 264-7200.

The surviving spouse and dependent children of veterans receiving disability benefits may also be entitled to monthly payments. Check with your regional VA office.

Employee Benefits

If the deceased was employed at the time of death, you should contact the employer regarding any benefits for the survivors. The employer may have provided life, health or accident insurance which will yield payments. The deceased may be due a final paycheck for vacation or sick leave. If the death was work-related, there may be worker’s compensation benefits.

Check for credit union accounts through the deceased’s employment. Self- employed persons can also have pension plans. Look for pension deposit deductions on past income tax returns.

You should contact all past employers, including federal, state or local governments, to determine if the survivors of the deceased are entitled to any payments from a pension plan.

Also check with the employer to see if the deceased belonged to a union or professional organization. These groups may offer death benefits for their members.

If the deceased was already retired and receiving a pension, you should check with the former employer to determine if survivors will continue to receive a pension payment or whether the payment will be reduced.

-36-

Form Characteristics

Fact Name Details
Importance of Notification It is essential to notify insurance companies promptly after the death to begin the claims process for life insurance benefits.
Document Location Locate all life insurance policies, premium notices, and correspondence. Review checking accounts and records for hints about existing policies.
Filing Requirements Insurance companies typically require a completed claim form and a death certificate. Additional documents may be requested based on individual circumstances.
Social Security Eligibility Eligibility for Social Security benefits requires the deceased to have paid into the system for at least 40 quarters. Apply promptly to avoid loss of benefits.
Medical Information Bureau This bureau can provide names of companies the deceased applied to. However, only a small percentage of applications are reported.

Guidelines on Utilizing Life Insurance Death Claim

Completing the Life Insurance Death Claim form is an important step in securing any benefits associated with the deceased individual’s life insurance policies. To proceed smoothly, gather all necessary information and documentation before starting. This preparation will streamline the filing process and help avoid any delays. Here’s how to fill out the form:

  1. Begin by reviewing the life insurance policy details to confirm the insurance company and the policy number.
  2. Provide full name, date of birth, and Social Security number of the deceased in the designated fields.
  3. Fill in the date of death, making sure it matches the death certificate.
  4. Write your relationship to the deceased. This may be crucial for the company to understand your claim's validity.
  5. Specify your legal capacity to claim the benefits, selecting from options such as beneficiary, executor, or administrator.
  6. Complete the contact information section with your own details, including address, phone number, and email.
  7. Attach a certified copy of the death certificate to the form.
  8. If applicable, include documentation proving your legal right to receive the claim, such as a marriage certificate or a court appointment certificate.
  9. Review the entire form for accuracy, ensuring all information is complete and correctly stated.
  10. Sign and date the form in the specified area to validate the claim.
  11. Make a photocopy of the completed form and all attached documents for your records.
  12. Submit the form and supporting documents to the insurance company following their submission guidelines.

What You Should Know About This Form

What is a Life Insurance Death Claim form?

A Life Insurance Death Claim form is a document that beneficiaries submit to an insurance company to claim the death benefits after the insured individual passes away. This form officially notifies the insurer of the death and requests payment of the benefits according to the policy terms.

What documents are typically required to file a claim?

To file a life insurance death claim, you will generally need two key documents: the completed claim form and the deceased person's death certificate. Depending on the insurer, additional documentation may be requested. This documentation could include, but is not limited to, the attending physician's statement, proof of identification for the claimant, and any relevant affidavits regarding the status of the deceased’s estate.

How can I locate life insurance policies for the deceased?

To locate life insurance policies, start by reviewing any official documents and correspondence that belong to the deceased. This includes premium notices, bank statements, credit card bills, and correspondence related to financial matters. Additionally, reaching out to close friends, relatives, life insurance agents, or financial advisors who may have interacted with the deceased can be helpful. Consider checking with the Medical Information Bureau, which can provide names of companies where applications were submitted.

What should I do if I cannot find any life insurance policies?

If you cannot locate any life insurance policies, consider requesting assistance from the Missing Policy Service offered by the American Council of Life Insurance. This service allows you to submit a request to search for policies across many major insurance companies. The process may take three to six months, during which the companies will review their records to see if there was an active policy in place for the deceased.

Who can file a death claim on behalf of the deceased?

The person legally entitled to receive the life insurance proceeds can file the claim. This typically includes named beneficiaries, executors of the estate, guardians, or trustees. If the beneficiary is deceased, you will need to provide that person's death certificate along with your claim.

Are there any time limits for filing a claim?

While life insurance policies generally do not impose a strict time limit for filing a claim, it is advisable to submit your claim as soon as possible. Delays might complicate the process, particularly if there are disputes over the policy or if the insurer needs more documentation to process the claim.

What if the insurance company requests additional information?

Insurance companies may sometimes request extra information or documentation to process a claim. It is essential to promptly provide the requested information to avoid delays. If needed, you can ask the insurance company for clarification on what specific information is required.

Can I claim Social Security benefits after the death of a spouse?

Yes, survivors may be eligible for Social Security benefits after a spouse’s death, provided they meet certain criteria. It’s important to file the claim as soon as possible, as there can be financial implications for delays. Documents such as the deceased's birth and death certificates, marriage certificate, and Social Security numbers are required when applying for these benefits.

What if the deceased was a veteran?

Survivors of veterans may be entitled to various benefits, including a lump-sum payment for burial expenses and allowances for grave plots. Veterans and their families can seek further assistance through the Department of Veterans Affairs to understand the specific benefits available based on the deceased's service record.

Common mistakes

Filling out a Life Insurance Death Claim form is a crucial process during a difficult time. Understanding the common mistakes people make can streamline the filing experience and ensure timely benefits. Below are ten common pitfalls.

One prevalent error is not gathering all necessary documents. It is essential to collect all life insurance policies, the death certificate, and any other relevant paperwork before starting the claim process. Missing even one document can delay the entire procedure.

Another mistake involves inaccurate information. Careful attention to detail is critical. Errors in names, dates, or other personal information can lead to confusion or even denial of the claim. The deceased’s full name, date of birth, and the official cause of death should all be verified before submission.

Failing to identify all potential policies can be detrimental. Sometimes, individuals may overlook older policies or those held by different insurance companies. A thorough search of the deceased's records and accounts can help uncover these policies, preventing potential financial loss.

Many people make the mistake of submitting the claim without proper authority. If the claimant does not have the legal right to file the claim, it will be rejected. Identifying who is legally entitled—whether a spouse, child, or estate representative—is essential. In some cases, court documentation may be necessary to prove authority.

Another issue arises when individuals neglect to follow the insurance company's guidelines. Each insurance company may have different requirements and procedures. Carefully reviewing these guidelines ensures that all necessary steps are followed, improving the chances of a swift resolution.

Some claimants may also overlook the importance of a guardian in specific situations. If the deemed beneficiaries are minors or legally incompetent, proper representation is required to file the claim. If not handled correctly, this could lead to delays in receiving benefits.

Moreover, not providing sufficient identification is a common misstep. When filing for claims, adequate identification must accompany the claim to confirm the claimant's identity and right to the benefits. The necessary paperwork might include Social Security numbers or court-issued documents.

A common thought is that once the claim is submitted, it is out of mind. However, failing to follow up with the insurance company can lead to missed information or delays. Regular communication with the insurer can help clarify any outstanding issues or requirements swiftly.

Lastly, many people mistakenly think that all benefits are automatic. In fact, benefits often require active application. For instance, if the deceased was a veteran or eligible for Social Security, separate applications must be submitted even after the insurance claim is filed. Awareness of this can create efficiency in accessing all available benefits.

In conclusion, by being mindful of these ten common mistakes, claimants can better navigate the Life Insurance Death Claim process. Each step taken carefully can alleviate some of the stress experienced during such a challenging time.

Documents used along the form

When filing a Life Insurance Death Claim, several supporting documents may be necessary to ensure a smooth process. These other forms and documents can help establish entitlement to benefits and provide vital information for the claim. Below is a list of documents often required alongside the Death Claim form.

  • Death Certificate: This official record confirms the passing of the individual and is usually required by the insurance company to process claims.
  • Claimant’s Certificate: This document certifies the individual making the claim is legally entitled to the proceeds. It specifies their relationship to the deceased.
  • Medical Information Bureau Report: This report outlines previous insurance applications and companies contacted about the deceased. It helps confirm any existing policies.
  • Social Security Records: These documents help verify the deceased's eligibility for social security benefits. Required information includes names, birth dates, and death dates.
  • Policy Documents: Any documentation related to the deceased’s life insurance policies, including copies of old policies and applications, may assist the claims process.
  • Financial Statements: Bank statements or financial records can help trace insurance payments and verify claims related to premiums paid.
  • Executor’s or Administrator’s Documentation: If the claim is to be paid to the estate, documents proving the executor or administrator’s authority are necessary to ensure the claim can be processed legally.
  • Funeral Bill: The funeral expenses may be part of the claim, so a detailed bill showing costs incurred can be required for reimbursement.
  • Birth Certificates of Dependent Children: If there are survivor benefits being claimed for minor children, their birth certificates may be needed to prove dependency.
  • Marriage Certificate: If the spouse is claiming benefits, this document may be required to establish the relationship to the deceased.

Gathering these documents can greatly enhance the chances of a successful and timely claim. Each document plays a unique role in confirming details and establishing entitlement, making the claims process easier during a difficult time.

Similar forms

  • Health Insurance Claim Form: Similar to the life insurance death claim form, this document is used to request payment for medical expenses incurred by a deceased individual. Both forms require proof of the individual’s identity and information about the services rendered.
  • Funeral Assistance Claim Form: This form is submitted to request financial help for funeral expenses. It often requires a death certificate, much like the life insurance claim. The focus here is on proving the incurred costs related to the burial.
  • Social Security Death Benefit Application: This application is filed to access death benefits from Social Security. It too necessitates documentation verifying the deceased's identity and proof of death, similar to the life insurance claim process.
  • Veterans Affairs Beneficiary Claim Form: Survivors of veterans may use this form to claim burial and funeral benefits. Like the life insurance death claim form, it requires proof of relationship and documentation regarding the veteran's service.
  • Accidental Death Benefit Claim Form: If the death was due to an accident, this form may be required to claim specific benefits. This document, like the life insurance claim, demands proof of the situation surrounding the death.
  • Disability Insurance Claim Form: This is filed if the deceased had disability insurance benefits prior to passing. Similar documentation is often necessary to support the claim, paralleling what is required for life insurance claims.
  • Estate Claim Form: When individuals seek to claim assets from an estate, this form is used. It often requires verification of relationship to the deceased, similar to what is seen in life insurance claims.
  • Property Insurance Death Benefit Form: If the deceased had property insurance that includes death benefits, this form is filed to recover those benefits. Proof of identity and death is a common requirement across both types of documents.
  • Retirement Plan Beneficiary Form: This form allows beneficiaries to claim benefits from the retirement accounts of the deceased. Just like life insurance claims, it requires clear proof of the beneficiary's relationship to the deceased.
  • Unclaimed Property Form: If benefits from the deceased went unclaimed, this form can be submitted to recover those assets. Documentation proving the decedent's identity and the nature of the claim is typically similar to that needed for life insurance claims.

Dos and Don'ts

Here are seven recommendations for filling out the Life Insurance Death Claim form, including things you should and shouldn't do:

  • Do safeguard all relevant life insurance policies or premium notices.
  • Don't discard any documents that appear official, especially those related to life insurance.
  • Do check the deceased’s financial records, such as checking accounts and credit card statements, for indications of life insurance.
  • Don't overlook contacting friends, neighbors, and relatives who might have information about existing life insurance policies.
  • Do reach out to life insurance agents or brokers previously associated with the deceased.
  • Don't assume that a policy has lapsed just because premiums were not paid; look into whether it could still be in force.
  • Do file the claim promptly, as delays can lead to unnecessary complications in accessing benefits.

Misconceptions

Misconception 1: Life insurance policies automatically cover all death-related expenses.

Many believe that life insurance proceeds can be used for any expenses incurred after a death. In reality, benefits are designated for specific beneficiaries and may not cover all costs associated with burial or other final expenses.

Misconception 2: The Life Insurance Death Claim form requires approval from all family members.

Some people think that all family members must agree before a claim can be filed. In fact, only the person legally entitled, such as a beneficiary or executor, needs to submit the claim form.

Misconception 3: You do not need a death certificate to file a claim.

A common misunderstanding is that a death certificate is optional. Most insurance companies require a copy of the death certificate to process the claim and determine beneficiaries.

Misconception 4: Claims can be filed by anyone, regardless of their relationship to the deceased.

It is often assumed that any person can file a claim. In reality, only designated beneficiaries, executors, or legal representatives may submit claims, ensuring that the right individuals receive the benefits.

Misconception 5: Life insurance companies are obligated to pay claims immediately.

Many assume that once a claim is filed, payments will be made quickly. However, insurance companies can take time to investigate claims. They can request additional information and may have a review process that can extend the timeline for payment.

Key takeaways

Understanding how to fill out and use the Life Insurance Death Claim form is essential for beneficiaries. Here are some key takeaways to guide you through the process:

  • Locate All Insurance Policies: Ensure you find every possible life insurance policy. Look for premium notices and other official documents that might indicate the existence of insurance coverage.
  • Contact Insurance Companies Promptly: Notify insurance companies about the death as soon as possible. This initiates the claims process.
  • Gather Required Documents: Typically, you need a completed claims statement and a death certificate. Additional information may be requested by the insurance company.
  • Identify the Claimant: The person making the claim must be legally entitled to the proceeds. This could be a named beneficiary or an executor of the estate.
  • Use Additional Resources: If the policy is missing, contact the Missing Policy Service or the Medical Information Bureau to help locate insurance information.
  • Claim Social Security Benefits: Check eligibility for Social Security death benefits. Complete necessary applications promptly to secure any available funds.
  • Consider Veteran’s Benefits: If the deceased was a veteran, explore potential burial benefits and other assistance available for veterans' families.

By keeping these points in mind, you can navigate the claims process more efficiently and ensure that you receive any benefits owed to you or your loved ones.