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Even if you only want to change the contingent beneficiary, you must confirm the primary beneficiary. When you visit Protective's websites, we may collect personal information from you via your browser or device, or through the use of cookies, analytics tools, and other technologies. A variety of life changes may impact who you need to have as your beneficiary. It is not intended as investment advice and does not necessarily represent the opinion of Protective Life or its subsidiaries. SIGN HERE FOR CHANGE OF BENEFICIARY REQUEST(S) Protective Life Insurance Company agrees that, if the policy requires endorsement or amendment for the requested change of beneficiary, recording and mailing a copy of this form will constitute such endorsement or amendment. endstream endobj 393 0 obj <>/ProcSet[/Text]>>/Subtype/Form/Type/XObject>>stream When you purchase life insurance, you'll be asked to name a beneficiary on your policy. NE, Cedar Rapids, IA 52499 1 BEN-CCC 02/14 Beneficiary Change Form Life is ever-changing. Not available in New York. The Change of Beneficiary Form is attached. Life insurance from Protective can help provide financial security for your loved ones when they may need it most. Examples of wording that can be used to designate a beneficiary on this Form are set forth below. Insurance and annuities are issued by PLICO in all states except New York and in New York by PLAIC. Protective Life believes that caring for beneficiaries is at the heart of our purpose as a company. Download Life Insurance Claim Forms Booklet contains following form #’s 15-43505-06; 15-47910-00; 15-40749-02; 15-16547-09 For information about Protective Life and its products and services, visit www.protective.com. 388 0 obj <> endobj Beneficiary nomination (102G-E) Use this form to name or change a beneficiary (the person or people who get the payment after you die) for your life and accidental death benefits. RiverSource Life Insurance Company 70100 Ameriprise Financial Center, Minneapolis, MN 55474 This form is used to establish a beneficiary and to change the beneficiary designation of a life insurance policy, deferred annuity and annuitized annuity contract. x�+�2R0R04�32U��31U(J� x�3�37�402VH�2P0P04�32U04�31U(J�J� e\R endstream endobj 392 0 obj <>/Subtype/Form/Type/XObject>>stream If you wish to designate more than five individuals as primary or contingent beneficiaries, attach a … 443 0 obj <>stream Product guarantees are backed by the financial strength and claims-paying ability of the issuing company. Genworth’s life insurance forms will assist you with making changes to your index universal life, guarantee universal life, term life insurance and whole life insurance accounts. We encourage you to consult with your financial adviser and legal or tax adviser regarding your individual situations before making investment, social security, retirement planning, and tax-related decisions. The company indicated in this section is referred to as "the Company." Insurance and annuity products are offered through PLICO in all states except New York where products are offered through PLAIC. Life Insurance Claims. Protective Life & Annuity Insurance Company West Coast Life Insurance Company When you visit Protective's websites, we may collect personal information from you via your browser or device, or through the use of cookies, analytics tools, and other technologies. The form can be accessed online here. C�R���L�B�c*HW�)O�w�S�h�4����>N����K>�����'�kl��Ŵ��c��{�]L�X Metropolitan Life Insurance Company Metropolitan Tower Life Insurance Company. Please visit our Privacy Policy for more information about our information practices, including information about your privacy choices. To report a death on a MONY or EFLOA Life Insurance Policy, download the claim form through the link below or call our Claims Service Center at 1-800-659-1058. %PDF-1.6 %���� �@E��}�+�gwf�mŐZ�KHR��l���^5(���\�L�p�bƊ�|�����G|w����Lʘ�b��Ĝ�A�-�[`�^c Protective Life Insurance Company agrees that, if the policy requires endorsement or amendment for the above requested change (s), recording and mailing a copy of this form … You will need to complete a change of beneficiary form. Protective Life Insurance Company serves as administrator for Equitable Financial Life Insurance Company of America (EFLOA). To notify Protective of a the loss of a loved one, you can also fill out this online form. t�''��b^b;� ,&�̺�WDR��jH�R0p�mջ�î���"��3�:t*v2v"R�s��.p����Q�����:�o�?��L'�o���o�2�����u>)�B���+[�[���ƙ��f���o˗�hܞ���Ɂ�̆����J}Kc#5��,�F���Jk�.j� ����k=�d�Z��%M�b$5�%H��-D�k�GW7������}�;N�w�P��9��� ���) �m� (i�Z�)�*�B����iY. If you are a resident of any state other than Massachusetts, use this form to change the beneficiary of your policy. Box 12687 Birmingham, AL 35202-6687 Designation Information: Beneficiary - All beneficiary changes MUST include the designation of a primary beneficiary. How much life insurance is going to cost depends on many different factors, such as your age and health. Use this form to change the Beneficiary where the Owner is the Insured and the new Beneficiary is an individual. �gB:ô�L(M��������#���\dʄ�ä�Dl����EĞ�TC5�1 %�t��u`����(�����)N Even if you only want to change the contingent beneficiary, you must confirm the primary beneficiary. Overnight Mail Protective Life Insurance Company 2801 Hwy 280 S Birmingham, AL 35223 Changing Your Beneficiary (Complete the Request to Change Beneficiary section) (continued) Special Beneficiary Designations (Use the Additional/Special Beneficiary Requests section) For the following designations, include the information shown in the quotations (as well as any other identifying information described in this section.) sign here for change of beneficiary request(s) Protective Life Insurance Company agrees that, if the policy requires endorsement or amendment for the requested change of beneficiary, recording and mailing a copy of this form will constitute such endorsement or amendment. Things such death, marriage, having a child, divorce, and other events can drastically change your life in the blink of an eye. It is important to keep beneficiary designations updated. You will need to complete a change of beneficiary form which can be obtained online here. %%EOF Individual Life Insurance Service Forms. A move that takes you out of state or out of the country, When a minor beneficiary reaches the age of 18, You become the caretaker of an elderly parent or parents. endstream endobj 394 0 obj <>stream The Claims Service Center is open Monday through Friday, 8 a.m. to 5 p.m. EST. These forms will help you conduct life insurance authorizations, requests, name/address change, naming a beneficiary … Call 800-866-9933 to speak to a Protective Life Insurance customer service representative. Settlement Option is not available unless elected on Beneficiary, Rights and Settlement Option Request (Form 4113). The most important thing to remember is that you shouldn't wait to make updates and changes to your will or life insurance policy. For this reason, it's important that you regularly review your will and life insurance policies to ensure that your beneficiary designations are up to date. Protective Series Estate Maximizer (ICC18-SPWL7), is a single premium whole life insurance policy issued by Protective Life Insurance Company (PLICO) in all states except New York where it is issued under (SPWL-7 NY 5-18) by Protective Life and Annuity Insurance Company (PLAIC). Life insurance change of Beneficiary - Short form. “Equitable” is the brand name of Equitable Financial Life Insurance Company of America (EFLOA). +q Upon receipt of the completed form, we will forward to the policyowner an acknowledgement of the complete change. Beneficiary nomination with optional benefits (102G-OPT-E) Use this form to name or change a beneficiary for your optional life and accidental death benefits. h�b```�����" ��ea���$�����$��O����`��n�3�RY����P��"�;8Pt )^N�J��@���o23H30� 2Yx'0�9?`�b�W�X���A1�ug>���u�^o�!����u �m|��* 000���3��2)���gഋ�,B{�~e���Q�p � �z+� That form will take precedence over any FEGLI designation form on file, as long as you sign it, have two witnesses sign, and complete the rest of the form properly. Metropolitan Life Insurance CompanyMetropolitan Tower Life Insurance Company Find the required service forms to make a change to your life insurance policies. Children as a group. M��,.��@. Get a quote for term life insurance. What Life Insurance Product is Right for Me? Neither Protective Life nor its representatives offer legal or tax advice. Descriptions of financial products contained in Learning Center articles are not intended to represent those offered by Protective Life or its subsidiaries. Transamerica Life Insurance Company Transamerica Premier Life Insurance Company Fax Number 1-800-235-4782 Administrative Office located at: 4333 Edgewood Rd. 410 0 obj <>/Filter/FlateDecode/ID[<769C0D9D9D300741B87A0CF81B25B854><8820FAAA29DFD043A0F452C7459A329F>]/Index[388 56]/Info 387 0 R/Length 112/Prev 614811/Root 389 0 R/Size 444/Type/XRef/W[1 3 1]>>stream 0ed81304-74f8-4d32-947d -3c9d8d794c9d. Each company is solely responsible for the financial obligations accruing under the products it issues. endstream endobj startxref Unless otherwise indicated, the right to change the beneficiary is reserved by the owner(s). (formerly Liberty Life Insurance Company, Investors Insurance Corporation, Magnolia Life, Southern Life, State National, Kentucky Central, RBC Insurance, Business Mens Assurance Company) ... Policy Change Forms. Payment will be made in one sum. During this process, please feel free to reach out at any time. Not for use with consumers. The information presented is for educational purposes and is meant to supplement other information specific to your situation. SERVICE REQUEST FORM Protective Life Insurance Company P.O. If you are a resident of Massachusetts, use this form to change the beneficiary of your policy. For more information on who will receive life insurance proceeds when an insured person dies, please check out our FAQ pages. Insurance and Annuities are:  Not a Deposit | Not Insured by any Federal Government Agency | Have no Bank or Credit Union Guarantee | Not FDIC/NCUA Insured | May Lose Value. 0 INSTRUCTIONS FOR COMPLETING THIS FORM Section 1. All Learning Center articles are general summaries that can be used when considering your financial future at various life stages. ���2PHbw.�.��D�$C��4.=cKSc=c��. IDI is located in Birmingham, Alabama. Life insurance change of Beneficiary Use this form to change Beneficiaries on your life insurance policies. endstream endobj 389 0 obj <>/Metadata 19 0 R/Pages 386 0 R/StructTreeRoot 50 0 R/Type/Catalog>> endobj 390 0 obj <>/MediaBox[0 0 612 792]/Parent 386 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 391 0 obj <>/ProcSet[/Text]>>/Subtype/Form/Type/XObject>>stream This form is used to request an address change on a life insurance or fixed annuity policy. Completed forms can be mailed, faxed or emailed to customer service for processing. 1. Whether you're looking to protect your family's lifestyle or pass along a legacy for the next generation, we can help. SIGN HERE FOR CHANGE OF BENEFICIARY REQUEST(S) Protective Life and Annuity Insurance Company agrees that, if the policy requires endorsement or amendment for the requested change of beneficiary, recording and mailing a copy of this form will constitute such endorsement or amendment. Upon completing the form, you should mail it to MONY PO BOX 4830 Syracuse, NY 13221 Address Change Request. MONY Life Insurance Company ("MONY") is a wholly owned subsidiary of Protective Life Insurance Company. Designation of Beneficiary and Method of Payment. Make sure you have the coverage you need with a term life quote from Protective Life. Premiums increase annually after the initial guaranteed premium period. Companies and organizations linked from Learning Center articles have no affiliation with Protective Life or its subsidiaries. Protective Life Insurance Company Life and Health Insurance Administration P.O. h��XkO#��+����_�i�dlse���rcY�`0���=l��S�3�f�!J"��WuUuթ�j��3-$�¢WLZ�^3�O���f4�[�G�� Form #15-29022-01. It's important to understand what that means so you can know your options. Make sure you have the coverage you need with a term life quote from Protective Life. Here, you'll learn the basics about a life insurance beneficiary and the beneficiary options you have as you make these key decisions. The decision of changing beneficiaries depends on many different factors and your individual life/financial situation. Common reasons for changing designated beneficiaries include: It is crucial that you keep the information regarding your beneficiaries up to date to ensure benefits are paid according to your desires. Protective.com; For financial professional use only. Refer to your policy/contract to determine when death benefits are payable. If you do, your assets may not be distributed as you may have wished. Beneficiary Change Form: Non-Massachusetts Resident. Protective ® Classic Choice Term (ICC16-TL21 / TL-21) is a term life insurance policy issued by Protective Life Insurance Company, Birmingham AL. @� �d� Upon completing the form, you should mail it to our office. Learning Center articles may describe services and financial products not offered by Protective Life or its subsidiaries. Protective® is a registered trademark of Protective Life Insurance Company. Complete Online: Download PDF: Beneficiary Change Form: Massachusetts Resident. Complete the beneficiary designation (FIRST, SECOND), using the sample wordings on Page 2 as a guide for completing your designation. It also depends on the type of policy you buy and the amount of the death benefit that you select. Ownership, Beneficiary, or Name Change Request Booklet. Percentage: designations must equal 100%. Policy form numbers, product features and availability may vary by state. Protective and Protective Life refer to Protective Life Insurance Company (PLICO) and its subsidiaries, including Protective Life and Annuity Insurance Company (PLAIC). x�-˱ h�bbd```b``6 �� �i#�d�7��.��Xfo�,�`��`�%� �`�L� ��S��[email protected]��]�,`�l��A��:@�#�� �C����8�! Beneficiary - All beneficiary changes MUST include the designation of a primary beneficiary. If a trust is being named, indicate the full name of the trust and the date it was established as well as the first and last page of the trust. SIGN HERE FOR THE ABOVE REQUEST(S) Please read the Signature Requirements to avoid a delay in processing. The same is true for your life insurance. © Protective Life Corporation, Birmingham, AL. When you buy a life insurance policy, you must designate a beneficiary, or someone to receive financial compensation in the event of your death.However, selecting a beneficiary may present you with situations where you'll need to specify how your life insurance benefits will be handled. Product availability and features may vary by state. We try to make this process as simple as possible for you. For this reason, it's important that you regularly review your will and life insurance policies to ensure that your beneficiary designations are up to date. When you visit Protective's websites, we may collect personal information from you via your browser or device, or through the use of cookies, analytics tools, and other technologies. Protective and Protective Life refers to Protective Life Insurance Company (PLICO) located in Nashville, TN and its affiliates, including Protective Life & Annuity Insurance Company (PLAIC) located in Birmingham, AL. If not enough space is allocated, please utilize Section 7. Instructions for Completing the Change of Beneficiary Form . Note: These forms are in PDF format. 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