Claims Support

Life Claimant Statement - Nationwide

Fill this out to request payment of the death benefit.

Contestable Claimant Statement Form

Fill this out if the insured’s death occurred within the first two years of the policy issue date or reinstatement date.

HIPAA Release Form

This is your authorization allowing us to obtain the insured’s medical information, if needed. Typically, this is only required if the insured passed away within two years of policy issue date.

Next of Kin Affidavit

This is a sworn written statement that identifies all blood and adopted relatives of the insured. Once filled out, it will need to be notarized. Typically, this is only required if the insured passed away within two years of policy issue date.

Direct Deposit Authorization

Fill this form out if you’d like the payment to be deposited directly to your bank account.

Our goal is to pay every claim as quickly as possible. For claims that do not require a medical review, we issue payment within 7-10 business days from the time we receive all claim requirements, which includes completed forms and the certified death certificate.

However, if your claim is contestable, we must perform a more thorough review by obtaining historical medical records to validate the insured's health status at the time of application. It can take 45 days or more to process and pay the benefit depending how quickly we receive requested documents from the insured's treating healthcare providers. During this time, you will receive status updates by US mail. 

A contestable claim is a life insurance policy that is less than two years old when the insured dies (based on the policy issue date or reinstatement date). When this type of a claim is filed, we make sure that the information on the application was true and correct when the policy was issued.

The reason it can take so long is that we need certain information like the insured’s medical records. You can help us move things along by contacting medical providers directly and asking them to send us the information about the insured. In some cases, they may require you to fill out an additional authorization form specific to their office.

Yes, you can. Once we receive the documents from you, you can call our customer service team at 1-866-440-4047, Monday – Friday, 8 AM to 4:30 PM CST. We'll automatically notify you by mail of your claim status or if we need more information from you.

For your security, we currently only accept completed claims forms through the mail or fax. If you'd like to overnight your forms to us, you made do so at 777 Research Dr, Lincoln, NE 68521.

Each beneficiary needs to submit an individual claim kit that includes all necessary paperwork. We’ll pay each beneficiary their proceeds separately as we receive the required claim documents from each of them. 

There are two different ways to do this. The first way is to contact the funeral home who provided the services. The second way is to order copies yourself. You can contact the state or local health department in the state or county that the individual resided in at the time of death.

They are medical retrieval companies that we use to help us in obtaining the information needed to review your life insurance claim. 

Many times, medical facilities and providers need verification that the individual signing the HIPAA has the authority to do so on behalf of the deceased. Once you have completed the affidavit, we will send it to the medical provider(s) to allow them to release the records.

The next of kin is the legally married spouse followed by children. Some providers may require the informant on the death certificate sign the affidavit. 

We recognize this may be a difficult time for you and we're here to support. If you'd like help completing your life insurance claims forms, call us at 1-866-440-4047, Monday – Friday, 8 AM to 4:30 PM CST.

You can find more information on our Claims Support page.

You can go to your account and view a specific claim or prior Explanation of Benefits statements.

Probate is a legal process that takes place after someone dies. It involves identifying the person's final assets, paying their debts and distributing their estate.

Life insurance policies with a named beneficiary do not need to go through the legal process of settling one's estate to reconcile debts and distribute assets to their heirs.

Our team will send you a claim packet within 3-5 business days which will include a claim form and a foreign death questionnaire. We will need a death certificate, HIPAA documentation, information about the death of the American citizen abroad and a passport, airline ticket or green card from you.

If your claim is contestable, our team will send you a claim packet within 3 to 5 business days which will include:

• Claim form
• HIPAA – Authorization for Release of Medical Information
• Supplemental Contestable claim form
• Next of Kin Affidavit

You will need to return these completed documents along with a certified death certificate. Once these items are received, we will be able to begin our review process which will include collecting information concerning the insured's medical history prior to the application date. Information may need to be obtained from multiple medical providers. Some may even require you to provide additional information to release their medical records. These additional requirements may include:

• Completing the facility's own authorization form
• Next of Kin Affidavit
• Copy of your photo ID
• Estate documentation 

Each medical providers timeframe on submitting medical records to Lumico varies. We will continue to follow up with the facilities regularly until the information is received. However, you may be able to help expedite obtaining the medical records by contacting the medical office directly and request they forward the medical records to Lumico. Once we have received all requested medical records, we will finish the review process. 

Our team will send you a claim packet within 3-5 business days which will include a claim form. You will need to return this completed form along with a certified death certificate. Once all claim requirements are received, we will make a decision within 10 business days, if not sooner.   

If the primary beneficiary is deceased, we will require a copy of the death certificate.

• If the primary beneficiary died prior to the insured, any benefits payable will be paid to the remaining primary beneficiary(ies). If there are no other primary beneficiaries, then any benefits payable will be paid to the contingent beneficiary.
• If the primary beneficiary died after the insured, the benefits are payable to the Estate of the Beneficiary. 

If the beneficiary is a minor, we will require evidence of court appointed guardianship of the Minor's Estate.

If the beneficiary is the Estate of the insured, we will require evidence of the court approved legal representative over the Estate. Please provide the Tax ID number of the Estate of the insured. 

If the beneficiary is a trust, we will require a copy of the trust agreement and any amendments, including the signature page. Please note the Trustee Certification section of the claim form will also need to be completed by all trustees. Please use the trust's name when completing the claimant information section of the claim form and provide the Tax ID number of the trust. 

If the beneficiary has had a change in name, we will need a copy of the applicable marriage license, divorce decree or similar legal documents.

Our overnight mail address is:

777 Research Drive

Lincoln, NE 68521

If you think we have been misinformed, have additional information or if you do not agree with our decision, please provide your appeal in writing to our office at P.O. Box 83303, Lincoln, NE 68501-3303.  We will perform a formal review of the information you provide, and we will respond once our review is completed.