Common use of Process for DEATH BENEFIT claims Clause in Contracts

Process for DEATH BENEFIT claims. a. You will be required to provide us with a completed claim form, as well as the specific documents/information listed below. b. Specific claim validation documents/information that must be submitted to us: - A certified copy of the deceased’s ID; - A certified copy of the death certificate; - A copy of the notification of death form completed by a doctor (otherwise called a DHA-1663/DHA-1680 form); - A letter of executorship/authority when the benefit is payable to an estate; - A copy of the police report (for accidental death claims only); and - A copy of the motor vehicle accident report, if applicable (for motor accident death claims only). In addition to the above specific documentation/information required, if a claim is submitted by Your Spouse, then We will require: - A copy of Your spouse’s ID; and - A copy of the marriage certificate. When there is no Spouse, then We will require: - A copy of the ID of the person claiming; and - An affidavit by the person claiming confirming they are the sole dependant of the deceased or in circumstances where they are not the sole dependant, a supporting affidavit by another member of the deceased’s family confirming that the claimant is authorised to make the claim. c. We reserve the right to request additional supporting documents at any time if We are unable to validate the claim with all the information requested above.

Process for DEATH BENEFIT claims. a. You will be required to provide us with a completed claim form, as well as the specific documents/information listed below. b. Specific claim validation documents/information that must be submitted to us: - A certified copy of the deceased’s ID; - A certified copy of the death certificate; - A copy of the notification of death form completed by a doctor (otherwise called a DHA-1663/DHA-1680 form); - A letter of executorship/authority when the benefit is payable to an estate; - A copy of the police report (for accidental death claims only); and - A copy of the motor vehicle accident report, if applicable (for motor accident death claims only). In addition to the above specific documentation/information required, ; if a claim is submitted by Your Spouse, then We will require: - A copy of Your spouse’s ID; and - A copy of the marriage certificate. When there is no Spouse, ; then We will require: - A copy of the ID of the person claiming; and - An affidavit by the person claiming confirming they are the sole dependant of the deceased or in circumstances where they are not the sole dependant, a supporting affidavit by another member of the deceased’s family confirming that the claimant is authorised to make the claim. c. We reserve the right to request additional supporting documents at any time if We are unable to validate the claim with all the information requested above.

Process for DEATH BENEFIT claims. a. You will be required to provide us with a completed claim form, as well as the specific documents/information listed below. b. Specific claim validation documents/information that must be submitted to us: - A certified copy of the deceased’s ID; - A certified copy of the death certificate; - A copy of the notification of death form completed by a doctor (otherwise called a DHA-1663/DHA-1680 form); - A letter of executorship/authority when the benefit is payable to an estate; - A copy of the police report (for accidental death claims only); and - A copy of the motor vehicle accident report, if applicable (for motor accident death claims only). In addition to the above specific documentation/information required, ; if a claim is submitted by Your Spouse, then We will require: - A copy of Your spouse’s ID; and - A copy of the marriage certificate. When there is no Spouse, then We will require: - A copy of the ID of the person claiming; and - An affidavit by the person claiming confirming they are the sole dependant of the deceased or in circumstances where they are not the sole dependant, a supporting affidavit by another member of the deceased’s family confirming that the claimant is authorised to make the claim. c. We reserve the right to request additional supporting documents at any time if We are unable to validate the claim with all the information requested above.

Process for DEATH BENEFIT claims. a. You will be required to provide us with a completed claim form, as well as the specific documents/information listed below. b. Specific claim validation documents/information that must be submitted to us: - A certified copy of the deceased’s ID; - A certified copy of the death certificate; - A copy of the notification of death form completed by a doctor (otherwise called a DHA-1663/DHA-1680 form); - A letter of executorship/authority when the benefit is payable to an estate; - A copy of the police report (for accidental death claims only); and - A copy of the motor vehicle accident report, if applicable (for motor accident death claims only). In addition to the above specific documentation/information required, ; if a claim is submitted by Your Spouse, then We will require: - A copy of Your spouse’s ID; and - A copy of the marriage certificate. When there is no Spouse, then We will require: - A copy of the ID of the person claiming; and - An affidavit by the person claiming confirming they are the sole dependant of the deceased or in circumstances where they are not the sole dependant, dependant a supporting affidavit by another member of the deceased’s family confirming that the claimant is authorised to make the claim. c. We reserve the right to request additional supporting documents at any time if We are unable to validate the claim with all the information requested above.