Life insurance claims are paid after the Company ensures:

• You are the true beneficiary
• The policy is current and in force
• That all conditions of the policy have been met

Required documents

When filing a claim, these documents are necessary:

• Claim to USFL Life Insurance Form (Required for all beneficiaries listed on USFL policies)
• Original life insurance policy, if available
• Certified copy of death certificate

Important Notice: Please call our toll free number (800) 959-3894, Monday through Friday, 8:30 AM to 4:30 PM (Eastern) for further information.

Additional documents

Not all options are available to all beneficiaries. Depending on your personal situation, these additional documents may be necessary:

• Specified Income Options: Available when requesting claim proceeds as an income for a specified period or specified amount
• Life/Income Options: Available when requesting claim proceeds as a life income
• Interest Options: Available when requesting claim proceeds in an interest bearing contract
• Assignment of Benefits Form: Available when assigning all or part of claim proceeds to another party
• Statement as to Children Form: Available if the beneficiaries are the children of the insured, but not named in the beneficiary provision and/or if the policy covers more than the deceased person (i.e. children’s term rider, additional insured rider, etc.)
• Tax Withholding Election Statement: Special Payment (W-4P) Form: Available if a specified income option or life income option is elected
• Certificate of Appointments: If you are filing as executor, administrator or guardian
• Copy of Trust Excerpts Title: Appointment and signature pages and any amendment naming the successor trustee(s)
• Beneficiary Guide: To assist with important decisions after the loss of a loved one

Return all documents for USFL to:

Regular Mail

USFL, an Equitable Company
PO Box 1419
Charlotte, NC 28201-1419

Express Mail

USFL, an Equitable Company
8501 IBM Drive, Suite 150
Charlotte, NC 28262

FAX

USFL (855) 784-1586

You may also request these forms be mailed to you by calling:

• USFL toll free number (800) 959-3894, Monday through Friday, 8:30 AM to 4:30 PM (Eastern)
• The policyholder’s Financial Professional

If you need assistance at any time, we recommend that you check with your Financial Professional, or contact the customer service area applicable to your situation.

These forms are Portable Document Format (PDF) files. If your browser is not yet capable of reading PDF files, you can download the free Adobe® Acrobat Reader™ software at the following link: http://www.adobe.com/prodindex/acrobat/readstep.html. Instructions for installation are also found at that location.