Life Assurance Benefit and Dependant's Pension Benefit Claim Notification Form

Please don’t use this online notification form if you are part of the Legal & General Mastertrust scheme or if the policy is for an LLP or Spouse claim. You will find the relevant claim forms on our literature library, which can be completed and sent directly to us at groupprotection.benefitsmanagement@landg.com 

 

Intermediary details (if applicable)

About the scheme

The Group Protection policy number will start with a G and contain 9 numbers.

This is the date that the deceased joined the scheme

The Group Protection policy number will start with a G and contain 9 numbers.

This is the date that the deceased joined the scheme

Member details

This is the date the member commenced their employment

This means the employee must be in full active employment, physically and mentally able to perform all the duties associated with their normal job.

You only need to complete this section if the death occurred overseas. Please ensure that you send the original death certificate along with an official translation otherwise the claim could be delayed. We may ask you to complete a death abroad questionnaire in order for us to process your claim.

Life Assurance Benefit

Please provide the member's scheme earnings as per the date of death

This is the sum that you will be claiming under the scheme

Dependant's pension

Please provide the NI number of the dependant

e.g. Wife, Husband, Son, Daughter

Please provide the member's scheme earnings

This is the sum that you will be claiming under the scheme

Declaration

The benefit claimed should be payable in accordance with the contact(s) of insurance.

The policyholder should make sure the deceased was eligible and that, where earnings related, the benefit claimed is calculated in accordance with the definition of scheme earnings agreed for insurance purposes.

I agree to provide Legal & General’s Privacy Policy to the beneficiaries of a dependant’s pension.