File a Claim
Group Life Insurance or Accidental-Death and Dismemberment Insurance Rider Claims


If your certificate number issued to you is in a numerical value, Example: 1234567891, please only use the two forms below.

Accelerated Death Benefit Claim Form

Beneficiary's Statement for Death Claim Form

If this is an Employer Sponsored Term Life Product with your policy number beginning with AFL, please use the forms below.

Death Benefit Proceeds Claim Form

Life Waiver of Premium Claim Form

Please provide a certified copy of the deceased person's birth certificate and death certificate. If the cause of death is an injury or accident, include a copy of any related police report and/or newspaper articles.

Please date and sign all required forms where indicated.