Children's Life Insurance Claim Form
Policy Information
Policy Number
Insured Child's Name
Date of Birth
Date of Death
Place of Death
Cause of Death
Claimant Information
Claimant's Name
Relationship to Child
Contact Email
Contact Phone Number
Address
Additional Details
Supporting Documents
Comments or Special Instructions
Declaration
I hereby declare that the information provided is true and correct to the best of my knowledge.
Signature
Date