Prudential group life insurance claim form pdf
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Sectionmust be completed if the claim is for an employee/member, or for a dependent of an employee How to complete and submit a Group Life Insurance Claim Form. Complete Sections 1, 2, 3, 4, andof the Group Contract Holder Statement portion of the Group Life Insurance We’ve enclosed a Group Life Insurance claim form for the life insurance benefits. How to complete and submit a Group Life Insurance Claim Form. Making isions in the face of loss can be overwhelming. Complete Sections 1, 2, 3, 4, andof the Group Contract Holder Statement portion of the Group Life Insurance Claim Form. Prudential’s Alliance Account can make managing this process simple. Sectionmust be completed if the claim is for an employee/member, or for a dependent of an employee How to complete and submit a Group Life Insurance Claim Form. (Use for employee/member and dependent death claims) Please send the completed form and all attachments to: The Prudential Insurance Company of America Group Life Claim Division P.O. Box Philadelphia, PA TelFaxTo be completed by Employer/Plan Administrator Complete Sections 1, 2, 3, 4, andof the Group Contract Holder Statement portion of the Group Life How to complete and submit a Group Life Insurance Claim Form. Complete Sections 1, 2, 3, 4, andof the Group Contract Holder Statement portion of the Group Life Insurance Claim Form. Receive a bank transfer. Section. If your claim is approved, one of the Missing: pdf The Prudential Insurance Company of America Group Life Claim Division P.O. Box Philadelphia, PA This form is supplied as a convenience to potential claimants Please send the completed form and all attachments to: The Prudential Insurance Company of America Group Life Claim Division P.O. Box Philadelphia, PAHow to complete and submit a Group Life Insurance Claim FormComplete Sections 1, 2, 3, 4, andof the Group Contract Holder Statement portion of the Group Life Insurance Claim Form. OPTIONOPTIONReceive a lump sum check. must be completed if the claim is for an employee/member, or for a dependent of an employee OPTIONDeposit into an Alliance Account. We’re here to make this process as easy as possible. It’s a straightforward, secure way to manage and access your life insurance benefits Group Insurance Contract Holder Statement.