Customer Service Litigation Paralegal
Resume:
Teresa Hall
Prince George, VA
******.********@*****.***
Beneficiary Change Instructions and Helpful Hints
Please follow these instructions for completing the form: 1. Please use dark ink and print all information except signatures. 2. You must provide all information requested. Complete and accurate information will help expedite the claim process.
3. If there are multiple primary or contingent beneficiaries, they will share equally in the policy proceeds unless you indicate a percentage for each named beneficiary in the area indicated. Please note that the total of all percentages for each beneficiary category must equal 100%. Do not use dollar amounts. 4. If you use liquid paper or scratch out information, those changes must be initialed by the policy owner. 5. The current policy owner must complete and sign the bottom portion of the form. The witness to the policy owner’s signature must be a non-relative and not named as the new beneficiary. 6. If additional room is needed, please use a separate sheet of paper. Each page must include: a) the policy number and name of the insured, b) the information requested on the form, c) signature of the Owner(s) with the date signed and d) the signature of a witness. If you wish, you can make copies of this form and number them.
7. If the new beneficiary is a trust, the trust name and date must be included as the name information in the appropriate box on the form.
Helpful Hints for Naming a Beneficiary
A family member or members are the most common type of beneficiary designation. Designating a family member as beneficiary is usually not a problem as long as the person is not a minor. Work Experience
Example: Jane Doe
Jane
Fred Doe, son - 50%
Children should not be named as beneficiary unless there is a trustee named to handle the claim transaction. If there is no trustee, the insurance company must determine who has the legal authority to accept payment on behalf of the minor child or children which may delay payment of the proceeds. Example: Jane and Fred Smith, children, with John Doe as trustee if said children are minors. If you decide to name your children, please include the name, address, social security # and date of birth for each child. It is always a good idea to name a contingent beneficiary as the primary beneficiary may predecease the insured and if no contingent beneficiary is named, the proceeds would be paid in accordance with the policy provisions.
If a creditor is to be the beneficiary, the form should indicate the amount that is to go to the creditor. Example: XYZ Bank as its interest may appear with the balance payable to Jane Doe, spouse. If you name a funeral home as the primary beneficiary, please indicate “as their interest appears” and name a contingent beneficiary to receive any proceeds not paid to the funeral home. If you have any questions regarding a beneficiary designation, please contact our office toll-free at 1-800-***-**** or email us at ***@****.***.
Beneficiary Change Request
Beneficiary change requests can only be made during the lifetime of the insured. Upon the Insurer’s receipt of this completed form, the Beneficiary change will be effective as of the date it was signed by the Policyowner. However, the change will be subject to any payment that the Insurer may have made or actions it may have taken prior to receipt of the completed form. The Company may acknowledge receipt of this requested change but does not assume responsibility for its validity or legal effect or the rights and liabilities of any person.
This request supersedes and revokes all previous primary and contingent beneficiary designations. Important Instructions
1. If you name multiple beneficiaries and don’t want the proceeds paid in equal shares, please indicate a percentage for each beneficiary in the appropriate box. The total of all percentages in each section must equal 100%. A dollar amount cannot be used.
2. If additional space is needed, please attach a separate sheet which includes: a) the policy number and name of insured; b) the information requested in the box below; c) signature of Owner(s) along with the date; and d) the signature of a Witness.
3. If new beneficiary is a trust, the trust name and date must be included as the name in the information box below.
Please use dark ink and print all information except signatures. Section A - Policy information (you must complete this section) Policy Number-Insured’s Name
Policyowner’s Name Policyowner’s Social Security No. Policyowner’s Date of Birth Section B - Primary Beneficiary Information
Address City State Zip Code Phone Number
Primary – The undersigned hereby requests that all previous primary beneficiary designations and settlement options elected be revoked and makes the following designations: Social Security
Social Security
Number Date of Birth Relationship to Insured Percentage Address City State Zip Code Phone Number
Social Security
Social Security
Number Date of Birth Relationship to Insured Percentage Social Security
Address City State Zip Code
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