Proof of Loss Claimant Statement - Life Insurance - Genworth 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the Policy Number and Decedent Information section. Include the deceased's full name, maiden name if applicable, address, date of birth, and date of death.
3. Select the manner of death from the provided options: Natural, Accidental, Suicide, or Homicide.
4. In the Beneficiary/Claimant Information section, provide your full name or trust name along with your contact details including Social Security/Tax ID number and email address.
5. Choose your preferred life distribution settlement option. Options include Lump Sum or Interest Settlement. Ensure you complete any additional required fields based on your selection.
6. Complete the Substitute Form W-9 section if applicable, ensuring all tax classification boxes are checked correctly.
7. Finally, sign and date the form in the Declaration and Signature section to validate your claim.

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