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Riversource insurance and annuity death claim statement

Riversource insurance and annuity death claim statement 2025

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The document is a Death Claim Statement from RiverSource Life Insurance Company, outlining the process for beneficiaries to claim death benefits from annuity contracts. It includes instructions for completing the form, required documentation such as a certified death certificate, and various settlement options available to beneficiaries. The document also addresses tax implications, beneficiary identification requirements, and necessary signatures, including notarization. Additionally, it provides information on federal and state fraud warnings related to insurance claims.

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Click ‘Get Form’ to open the RiverSource Insurance and Annuity Death Claim Statement in the editor.
Begin by entering the decedent's RiverSource contract number at the top of Part 1. Ensure that all details are accurate.
Fill in the Contract Information section, including the state of residence, date of death, and deceased's full name. Select marital status from the provided options.
In Part 2, provide Beneficiary/Claimant Information. If the beneficiary is not a trust, complete Section A; if it is a trust, complete Section B. Include necessary details such as Taxpayer Identification Number and relationship to the deceased.
Proceed to Part 3 for Settlement Instructions. Choose your preferred settlement option based on whether it’s a nonqualified or qualified deferred annuity.
Complete Parts 4 through 6 as required, ensuring all signatures are notarized where indicated. Review all entries for accuracy before submission.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What does a death claim mean?

A claimants statement is a formal document submitted to an insurance company to request the disbursement of benefits following the death of a policyholder. It includes details about the deceased, the beneficiary, and relevant claim information.

What is a death claimants statement?

Like most civil claims filed in California, the statute of limitations for filing a wrongful death lawsuit is two years from the date of the victims death. Therefore, legal action must be initiated within this two-year timeframe.

What is a death claim statement?

Each beneficiary must complete and submit a signed claimants statement, which is typically included in the claims packet. Most forms ask for the policy number, basic information about the deceased, the claimants information, and settlement options, which is how a beneficiary wishes to receive the payout.

What is the phone number for RiverSource death claims?

Alternately, contact our corporate office at 1-800-862-7919. Tell the operator that youd like to report a death, and you will be connected to a RiverSource client service professional.

How long do you have to file a death claim?

Funeral Benefit is a lump-sum amount paid to whoever bore the funeral expenses of the deceased SSS member or pensioner. Death Benefit (monthly pension or lump-sum) is granted to primary or secondary beneficiaries if the deceased member met the minimum contribution requirements or was a pensioner at the time of death.