Claim death benefit form | Death insurance

First name*

Last name*

Phone number*

Email address*

Residential address

I have a different postal address

Do you identify as Aboriginal or Torres Strait Islander? Yes No

Relationship to the deceased person?*

Are you a solicitor or third-party authority acting on behalf of the claimant? Yes No

Do you prefer us to communicate through post, email, or phone? Post Email Phone

Make a death benefit claim