United Of Omaha Life Insurance Form

The change of beneficiary form is attached.

United of omaha life insurance form. The proof of death claim form should be returned to. Payment of the life insurance benefits will be paid in order as specified in the policy provisions of the contract. Hours worked per week. Ohourly omonthly oweekly osemi monthly obi weekly oannually date of hire.

Enrollment form united of omaha life insurance company. Providence healthcare management effective date. Important tips for paper copy submission. United of omaha life insurance company group life claims mutual of omaha plaza omaha ne 68175 0001 toll free 800 775 8805 fax 402 997 1835.

Complete the attached form and mail it to united of omaha life insurance company. Examples of wording that can be used to designate a beneficiary on this form are set forth below. Employer section to be completed by the employer. Your employer through united of omaha.

Required fields are marked with an asterisk employer name. The change of ownership of a life insurance policy may have tax. Complete this form and return it to. Upon the death of an insured employee plan member or insured dependent the employer plan administrator must complete the claim form as indicated and send attachments mentioned below.

Companion life insurance company hauppauge ny 11788 2934 is licensed in new york. If the policy proceeds are to be paid other than in a single sum do not use this form and contact united of omaha life insurance company for. Policyowner services policyholder services 402 997 1906 mutual of omaha plaza omaha ne 68175 note. Al ca co id il la nv nh ny nc pr ri vt vi and wi.

G000b3sn sub group id. Instructions for completing the change of beneficiary form. Do not use this form when assigning a policy for a loan instructions. The surviving heir must complete an affidavit of preferential beneficiary designation form which must be notarized.

United of omaha life insurance company group life claims. Omaha insurance company is licensed in all states except. United of omaha life insurance company attn. 3300 mutual of omaha plaza omaha nebraska 68175.