Extension deceased 2026

1. Click ‘Get Form’ to open the extension deceased document in the editor.
2. Begin by filling in your Claim Number and Policy Number at the top of the form. Ensure these details are accurate as they are crucial for processing your claim.
3. In Part 1, provide your personal information including Last Name, First Name, Birth Date, and contact details such as Work and Home Telephone numbers. This section is essential for identifying you as the applicant.
4. Part 2 requires you to enter information about your Insurance Company. Fill in the name of the representative, their address, and contact numbers to facilitate communication regarding your claim.
5. In Part 3, list details about your Treating Health Professional. Include their name, profession, and contact information to ensure they can be reached for necessary health disclosures.
6. Finally, complete Part 4 by signing and dating the authorization section. This consent allows your health professional to share relevant information with your insurer.

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