Step of

Step of

Step of

File an accelerated benefit

This form allows you to file a claim to receive an advance on the death benefit. It will take you about 10 minutes to complete and you will receive an initial follow-up within five business days once the claim is filed.

Your claim

Are you filing this claim for yourself?

Yes
No
Please make a selection.

About the claim follow-up

Whom should we contact to follow up on the claim?

Veuillez inscrire un prénom.
Veuillez inscrire un nom.
Please enter a valid telephone number.
Please enter a valid extension.
Please enter a valid telephone number.
Please enter a valid extension.
Email address used for claim follow-up
You will receive an acknowledgement of receipt after the claim is sent. Please enter a valid email address.
I don't have an email address
Please check the box if you do not have an email address.
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