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Get Fort Dearborn Life Insurance Company Death Claim Form 2007-2024

Ber: (800) 348-4510 Fax: (630) 824-5419 INSTRUCTIONS ANSWER ALL QUESTIONS FULLY AND SUBMIT ALL NECESSARY ATTACHMENTS TO AVOID UNNECESSARY DELAY AND CORRESPONDENCE Upon the death of the insured employee, member or insured dependent, the employer must complete the claim form as indicated below and send with all attachments to the address above. Complete the Statement of Employer fully and have signed by an authorized officer of the Group Policyholder. Attachments: You must submit a certifi.

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