Bereavement Claim Payment - (Discretionary) webform

We are collecting this information to help identify you and process your enquiry. Your contact details will be retained to support the on-going servicing of the policy. You can find out more about how we use personal information by viewing our full privacy notice here.

Please tell us the following information about the person that's died

The policy number for the policy they're connected with

It’s really important to provide the policy number as it will help us progress your claim more quickly. You'll find this in annual statements or other letters from us.

Policy number

If your claim relates to more than one policy number please add additional policy numbers below.

Add another policy Remove

Their title

Name

First Name

Last Name

Their date of birth

Their National Insurance Number

Their last known address:

Apartment Number / House Number / House Name

Street

Town/City

County

Postcode (if UK)

Country

Claim Payment Request Form

We know that coping with bereavement is a difficult and painful process, so we’ll do our very best to deal with your claim as quickly and smoothly as possible and provide any support we can along the way.

Completing the form usually takes about 10 minutes. Please use this form to provide us with details about yourself and the payment.

The policy number for the policy they're connected with