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Non-Qualified Claimant's Statement - Lincoln Financial

Non-Qualified Claimant's Statement - Lincoln Financial 2026

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The document is a Non-Qualified Claimant’s Statement from Lincoln National Life Insurance Company, outlining the process for filing a claim on an insurance contract. It includes instructions for completing the form, required information about the deceased and claimant, payment options, tax withholding elections, beneficiary designations, and certifications. The document emphasizes the importance of providing accurate information to avoid delays in processing claims and includes fraud warnings and privacy practices regarding personal information.

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Click ‘Get Form’ to open the Non-Qualified Claimant's Statement in the editor.
Begin by entering the Deceased’s Information, including the Claim Number, Contract Number(s), and personal details such as First Name, Last Name, and Date of Death.
Next, fill in your Claimant Information. Provide your name, relationship to the decedent, and contact details. Ensure you select your gender and citizenship status.
Select your preferred Payment Method. Choose from options like Lump Sum or Electronic Funds Transfer (EFT) and provide any necessary additional information.
Complete the Tax Withholding section by indicating your preferences for federal and state income tax withholding.
In the Election of Beneficiary Section, list primary beneficiaries with their respective percentages. Ensure that total percentages equal 100%.
Authorize transactions if desired by checking the appropriate box. Review all entries for accuracy before proceeding.
Finally, certify and sign the form. Ensure all required fields are completed before submitting it through our platform.

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2022	4.6 Satisfied (56 Votes)

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How do I email LFG disability documents?

Email us at: claims@LFG.com for any claims questions. clientservices@LFG.com for administration and other questions. You will receive a response within 24 hours or less.

What is a claimant statement?

The purpose of the statement of claim is to inform the insurance company that a covered loss has occurred and that the policyholder is seeking reimbursement.

How do I check the status of my Lincoln Financial disability claim?

If youve already submitted a claim, you can log in 24/7 to check your claims status. Registration is required. For DHMO benefit and claim information please visit (registration required) or call 888-877-7828. For vision benefit and claim information, please visit lvc.lfg.com or call 800-440-8453.

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