These forms will help you conduct life insurance authorizations, requests, name/address change, naming a beneficiary … Whether you're looking to protect your family's lifestyle or pass along a legacy for the next generation, we can help. If you are a resident of Massachusetts, use this form to change the beneficiary of your policy. endstream endobj startxref How much life insurance is going to cost depends on many different factors, such as your age and health. If you do, your assets may not be distributed as you may have wished. Insurance and annuities are issued by PLICO in all states except New York and in New York by PLAIC. 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. Individual Life Insurance Service Forms. 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. Instructions for Completing the Change of Beneficiary Form . NE, Cedar Rapids, IA 52499 1 BEN-CCC 02/14 Beneficiary Change Form The same is true for your life insurance. 1. Product guarantees are backed by the financial strength and claims-paying ability of the issuing company. Protective Life Insurance Company Life and Health Insurance Administration P.O. 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. Life Insurance Claims. Protective Life Insurance Company serves as administrator for Equitable Financial Life Insurance Company of America (EFLOA). 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. 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. MONY Life Insurance Company ("MONY") is a wholly owned subsidiary of Protective Life Insurance Company. Protective® is a registered trademark of Protective Life Insurance Company. 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. Insurance and annuity products are offered through PLICO in all states except New York where products are offered through PLAIC. 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. Complete the beneficiary designation (FIRST, SECOND), using the sample wordings on Page 2 as a guide for completing your designation. x�-˱ 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). “Equitable” is the brand name of Equitable Financial Life Insurance Company of America (EFLOA). SIGN HERE FOR THE ABOVE REQUEST(S) Please read the Signature Requirements to avoid a delay in processing. Upon completing the form, you should mail it to our office. Designation of Beneficiary and Method of Payment. 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. 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+� Payment will be made in one sum. If you wish to designate more than five individuals as primary or contingent beneficiaries, attach a … Transamerica Life Insurance Company Transamerica Premier Life Insurance Company Fax Number 1-800-235-4782 Administrative Office located at: 4333 Edgewood Rd. Booklet contains following form #’s 15-43505-06; 15-47910-00; 15-40749-02; 15-16547-09 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. Address Change Request. Learning Center articles may describe services and financial products not offered by Protective Life or its subsidiaries. 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. Securities offered by Investment Distributors, Inc. (IDI) the principal underwriter for registered products issued by PLICO and PLAIC, its affiliates. Download Life Insurance Claim Forms Find the required service forms to make a change to your life insurance policies. During this process, please feel free to reach out at any time. The company agrees that, if the policy requires endorsement or amendment for the above requested change of beneficiary, recording and The decision of changing beneficiaries depends on many different factors and your individual life/financial situation. 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. For more information on who will receive life insurance proceeds when an insured person dies, please check out our FAQ pages. Settlement Option is not available unless elected on Beneficiary, Rights and Settlement Option Request (Form 4113). 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. Life is ever-changing. For information about Protective Life and its products and services, visit www.protective.com. The most important thing to remember is that you shouldn't wait to make updates and changes to your will or life insurance policy. When you purchase life insurance, you'll be asked to name a beneficiary on your policy. Form #15-29022-01. 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. What Life Insurance Product is Right for Me? 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$5�%H��-D�k�GW7������}�;N�w�P��9��� ���) �m� (i�Z�)�*�B����iY. �@E��}�+�gwf�mŐZ�KHR��l���^5(���\�L�p�bƊ�|�����G|w����Lʘ�b��Ĝ�A�-�[`�^c Product availability and features may vary by state. Not for use with consumers. 0ed81304-74f8-4d32-947d -3c9d8d794c9d. Beneficiary Change Form: Non-Massachusetts Resident. ���2PHbw.�.��D�$C��4.=cKSc=c��. SERVICE REQUEST FORM Protective Life Insurance Company P.O. IDI is located in Birmingham, Alabama. © Protective Life Corporation, Birmingham, AL. Life insurance from Protective can help provide financial security for your loved ones when they may need it most. Children as a group. M��,.��@. %PDF-1.6 %���� You will need to complete a change of beneficiary form which can be obtained online here. Make sure you have the coverage you need with a term life quote from Protective Life. endstream endobj 392 0 obj <>/Subtype/Form/Type/XObject>>stream 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 We try to make this process as simple as possible for you. C�R���L�B�c*HW�)O�w�S�h�4����>N����K>�����'�kl��Ŵ��c��{�]L�X Refer to your policy/contract to determine when death benefits are payable. Life insurance change of Beneficiary Use this form to change Beneficiaries on your life insurance policies. Not available in New York. All Learning Center articles are general summaries that can be used when considering your financial future at various life stages. Ownership, Beneficiary, or Name Change Request Booklet. Please visit our Privacy Policy for more information about our information practices, including information about your privacy choices. It also depends on the type of policy you buy and the amount of the death benefit that you select. 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. Here, you'll learn the basics about a life insurance beneficiary and the beneficiary options you have as you make these key decisions. It is important to keep beneficiary designations updated. 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 h�bbd```b``6 �� �i#�d�7��.��Xfo�,�`��`�%� �`�L� ��S��[email protected]��]�,`�l��A��:@�#�� �C����8�! 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. 388 0 obj <> endobj If not enough space is allocated, please utilize Section 7. Protective Life believes that caring for beneficiaries is at the heart of our purpose as a company. Metropolitan Life Insurance Company Metropolitan Tower Life Insurance Company. 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. Protective ® Classic Choice Term (ICC16-TL21 / TL-21) is a term life insurance policy issued by Protective Life Insurance Company, Birmingham AL. 443 0 obj <>stream Unless otherwise indicated, the right to change the beneficiary is reserved by the owner(s). h��XkO#��+����_�i�dlse���rcY�`0���=l��S�3�f�!J"��WuUuթ�j��3-$�¢WLZ�^3�O���f4�[�G�� Examples of wording that can be used to designate a beneficiary on this Form are set forth below. Use this form to change the Beneficiary where the Owner is the Insured and the new Beneficiary is an individual. Call 800-866-9933 to speak to a Protective Life Insurance customer service representative. It is not intended as investment advice and does not necessarily represent the opinion of Protective Life or its subsidiaries. INSTRUCTIONS FOR COMPLETING THIS FORM Section 1. Neither Protective Life nor its representatives offer legal or tax advice. Completed forms can be mailed, faxed or emailed to customer service for processing. The company indicated in this section is referred to as "the Company." Companies and organizations linked from Learning Center articles have no affiliation with Protective Life or its subsidiaries. Is allocated, please utilize Section 7 the New beneficiary is an individual change the beneficiary of policy. Your family 's lifestyle or pass along a legacy for the next generation, we can help of form..., or name change Request Booklet Massachusetts, use this form to change the beneficiary of your.! Find the required service forms to make this process as simple as possible for you to this... 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