INITIAL CLAIM DOCS
These 2 forms require at least 1 phone number and a full address.
What are Form NOK Releases Forms A & G.
These two forms are equivalent to forms H and I for California. They are the final release forms for the funeral home and the funding company.
What are forms B & C.
_____ is used when a check payable to the estate of the deceased and the next of kin cannot cash it.
What is the form F (sworn statement of no probate estate).
This form is signed in order to assign the proceeds from one party to the funeral home. This is for standard policies only.
What is the Assignment of Insurance Proceeds Form.
This form states who they request we release funds to, possibly the funeral home or the next of kin.
What is the verified statement of performance form or the VSP form.
Equivalent to form J for California. This is the final release form for family when all funds from policy are being paid to them.
What is form D.
This form is utilized if the person signing the Next of Kin form is not eligible (not blood related). The Funeral Home will sign this form and send it back with the final release. This form is generated in QL.
What is the Form E or Indemnity Agreement.
If the GA state for the policy is Arkansas, the funeral home has to fill out this form with their information as an initial claim document.
What is the AR Seller’s Affidavit Form
This form is for tax purposes.
What is the W9 form
This is the release form for Trappist caskets.
What is form K
This form is utilized if we have a policy which ends in Z. We don’t have these policies' required settlement agreement on file. Before we can process the claim we need to have a signed copy of the settlement agreement on file.
What is the form L
This internal form is used to document when forms are received and deficiencies on required documents.
What is the LML Claim Worksheet.
On the ______ a processor can verify how much of the proceeds are owed to a funeral home, if any.
What is the funeral bill.
When generated in QL, the final releases (B, C, H, I) will give a prompt for the following information: The _____, _______, ______, _______, and _______.
What is the funeral home or funding company name, the address, the phone number, the email, the death benefit.
The form submitted by funding companies to verify that the beneficiary and/or funeral home releases funds to them. Used for both disputed and standard policies.
What is the Irrevocable Assignment and Power of Attorney and Irrevocable Re-Assignment.
In order to complete the claim checklist, this form is needed to verify the date of death, the residency state, and the manner of death. The submitted copy must be certified and legible.
What is the death certificate.