The purpose of this form is to capture the information we need to process your claim.
It may take up to 20 mins to complete but is the most efficient way to inform us of a death and send supporting documentation.

Once you've completed the form press 'Send'.
To find out more about our Privacy Policy click here.

If you don't have a Death Certificate that clearly states the 'Cause of Death'
or if the policy is assigned to Dignity for funeral arrangements Click Here