Get Accelerated Benefits Claim Forms

Filling out the Accelerated Benefits Claim Forms online is a crucial step for individuals seeking access to their benefits. This guide provides detailed instructions to help users navigate each section of the form with ease and confidence.

Follow the steps to successfully complete your Accelerated Benefits Claim Forms.

1. Use the ‘Get Form’ button to access the Accelerated Benefits Claim Forms. This will allow you to open the document and begin filling it out.
2. In the Policyholder/Employer’s Statement section, enter the name and address of the policyholder or employer. Specify the employee's or applicant's occupation and job title, followed by the first date of full-time employment and the effective date of insurance.
3. Indicate the employment status, either active, retired, or on a leave of absence. If retired or terminated, provide the relevant date. Also, document when the employee or applicant last worked.
4. Complete the form by including the policy number and specifying the amount of insurance. If applicable, indicate if the insurance has been terminated and provide details of any other considerations.
5. Provide the last month that the premium was paid, along with the annual salary of the employee or applicant, and their contact number.
6. In the Employee/Applicant’s Statement section, include the date of birth, social security number, and address. Answer whether there is currently an irrevocable beneficiary and, if so, include the beneficiary's signature and printed name.
7. Indicate if there are any assignments of the insurance and if a creditor or governmental agency has required exercise of this option, stating the amount of the accelerated benefit requested.
8. For policies issued in Mississippi, choose a payment option, either lump sum or installments, and specify the amount and duration if applicable.
9. Include the Attending Physician’s Statement for Accelerated Death Benefits as an attachment. Then, complete the authorization section confirming that the statements provided are accurate.
10. Finally, review the entire form for accuracy, then save your completed document. You may choose to download, print, or share the form as needed.

Complete your Accelerated Benefits Claim Forms online today for efficient processing.