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Begin by filling out the 'Insured and Deceased Information' section. Enter the primary insured's full name, any other names they may have been known by, and their policy number. Specify if the deceased is the primary insured, spouse, child, or other, and provide details such as cause of death, SSN, birth date, death date, gender, country where death occurred, and residence address at the time of death.
Next, complete the 'Beneficiary Information' section. Ensure that the beneficiary's name matches exactly as listed on the policy. Include their relationship to the deceased, SSN/TIN, birth date, address (including city, state, ZIP), and daytime phone number. If applicable, provide a different mailing address.
In the 'Preferred Payment Method' section, select your desired payment option: Lump Sum Check, Proceeds Held At Interest, or Installment options. Review your choice carefully as it cannot be changed later.
Finally, certify your taxpayer information in the 'US Taxpayer Certifications' section. Sign and date where indicated to complete your form.
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The University of Denver provides ADD coverage of 1x your current salary to a maximum of $100,000 at no cost to you. This coverage is in addition to yourRead more
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