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  1. We are requesting this information in order to process the claim you are presenting to our company. Therefore, please complete in detail, sign, date and return the following form to us. We cannot process your claim until we have this form returned to us.

  2. A PROPERLY COMPLETED CLAIM FORM WILL ASSIST US IN THE PROMPT PROCESSING OF YOUR CLAIM Return Proofs of Death (listed above) to: IF THE BENEFICIARY… Monumental Life Insurance Company has assigned the benefits, the claim form must be Claims Department completed by the beneficiary who must submit the original

  3. Monumental Life Claim for Life Insurance Benefits Home Office.

  4. Monumental Life Insurance Company. If we do not receive the completed claim form within 30 days of your receipt of the claim form, we will assume you no longer wish to file a claim.

  5. The document is a claim form for life insurance benefits from Monumental Life Insurance Company, requiring the submission of a completed form along with a death certificate and original policies.

  6. • I/We hereby apply for payment of the benefit(s) payable under the plan on the death of the life assured. • I/We declare that the information given above is correct and that entitlement to the benefit(s) claimed is in accordance with the terms of the plan.

  7. 24 Οκτ 2023 · As part of the claim process, you will need to fill out a claim form provided by American Monumental Life Insurance Company. This form requests essential information such as the insured’s personal details, policy information, cause of death, and your contact information as the beneficiary.

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