Get Lms 613500

The Lms 613500 form is essential for filing claims related to life insurance and accidental death benefits. Accurately completing this form can help ensure your claim is processed without delays.

Follow the steps to successfully complete the Lms 613500 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the employee or insured person's name, including last name, first name, and middle initial. Make sure to input the date of birth and social security number.
3. Indicate the gender of the insured by selecting 'M' for male or 'F' for female.
4. Provide the complete address of the insured person, including street, city, state, and zip code.
5. Select the marital status of the insured by choosing from the options: married, single, widow/widower, separated, divorced, or domestic partner.
6. Enter the policy number(s) of the insurance coverage.
7. Detail the occupation of the employee or member and check the appropriate employment/membership status boxes.
8. Complete the sections relating to insurance coverage including the effective date of earnings and the amount of insurance, specifying any voluntary or basic amounts.
9. If claiming for a dependent, fill out the dependent's name, relationship to the employee, and other relevant fields including amount of dependent insurance.
10. For accidental death claims, describe where and how the accident occurred and include the date and time of the incident.
11. Complete the employer's certification section, ensuring all details are accurate and include the necessary signature and date.
12. After all sections are filled out, review the entire form for completeness and accuracy before proceeding to save, download, print, or share the document.

Complete your Lms 613500 form online today for a smoother claims process.