Service Forms

Need to change your beneficiary? File a claim? Request a withdrawal? All of the forms you may need are just a few questions away.

First, we need to find out more about your product...

What type of contract or policy do you have?

Annuity
Structured Settlement Life Insurance
Accident & Health
Disability
Long Term Care
Accidental Death

What is the name of the issuing company listed on your contract or policy?

桔子视频 Annuity and Life Company
(also formerly Aviva Life and Annuity Company, 桔子视频 Life Insurance Company of New York)
桔子视频 Annuity & Life Assurance Company of New York
(also formerly Presidential Life Insurance Company)
桔子视频 Annuity & Life Assurance Company
(also formerly Liberty Life Insurance Company, Investors Insurance Corporation, Magnolia Life, Southern Life, State National, Kentucky Central, RBC Insurance, Business Mens Assurance Company)

What type of life policy do you have?

Term, Traditional and Universal
Whole
Variable

What was the original issuing company of your policy?

Liberty Life, RBC Insurance or Business Mens Assurance Company
Liberty Life (Mortgage Term Life)

What was the original issuing company of your policy?

Magnolia Life, Southern Life, State National or Kentucky Central
Liberty Life, RBC Insurance or Business Mens Assurance Company

What is the name of the issuing company listed on your contract or policy?

桔子视频 Annuity and Life Company
(also formerly Aviva Life and Annuity Company, 桔子视频 Life Insurance Company of New York)
桔子视频 Annuity & Life Assurance Company of New York
(also formerly Presidential Life Insurance Company)
桔子视频 Annuity & Life Assurance Company
(also formerly Liberty Life Insurance Company, Investors Insurance Corporation, Integon or Liberty Life Insurance Company, RBC Insurance, Business Mens Assurance Company)

What was the original issuing company of your policy?

Quincy
Other

Does your contract number begin with NY0, NY1 or 66?

Yes
No

Does your contract begin with:

VA01 or 05?
None of the above

What was the original issuing company name?

Investors Insurance Corporation
Integon, Liberty Life Insurance Company, RBC Insurance or Business Mens Assurance Company

What is the name of the issuing company listed on your contract or policy?

桔子视频 Annuity and Life Company
(also formerly Aviva Life and Annuity Company, 桔子视频 Life Insurance Company of New York)
桔子视频 Annuity & Life Assurance Company
(also formerly Liberty Life Insurance Company, Investors Insurance Corporation, Integon or Liberty Life Insurance Company, RBC Insurance, Business Mens Assurance Company)

What is the name of the issuing company listed on your contract or policy?

Your results...

Call 855-615-2276 to speak to a customer service representative.

Your results...

Call 877-462-8992 to speak to a customer service representative.

Your results...

Administrative Forms

Policy Change Forms

Withdrawal Request Forms

Tax Forms

Buyer's Guides

Claim Forms

- for beneficiaries of contracts in a payout/settlement status
- for beneficiaries of American Investors Life policies

Your results...

Call 888-266-8489 to speak to a customer service representative.

Your results...

Call 800-926-7599 to speak to a customer service representative.

Your results...

Call 800-866-9933 to speak to a customer service representative.

Your results...

Administrative Forms

Policy Change Forms

Withdrawal Request Forms

Transfer/Rollover Forms

Your results...

Call 800-234-5514 to speak to a customer service representative.

Your results...

Call 800-423-9398 to speak to a customer service representative.

Your results...

Call 866-626-1161 to speak to a customer service representative.

Your results...

Administrative Forms

Policy Change Forms

Withdrawal Request Forms

Transfer/Rollover Forms

Tax Forms

Your results...

Call 800-366-5463 to speak to a customer service representative.

Your results...

Mailing Address:

P.O. Box 1555
Des Moines, IA 50306-1555

Overnight Mailing Address:

7700 Mills Civic Parkway
West Des Moines, IA 50266-3862

Fax Number:
866-709-3922

Phone Number:
800-525-7133

Claim Forms

For claim forms, call 800-800-9882 to sp eak with a customer service representative.

Contact Information

Mailing Address:
P.O. Box 1555
Des Moines, IA 50306-1555

Fax Number:
800-531-0038

Phone Number:
800-800-9882

Contact Information

Mailing Address:
P.O. Box 1555
Des Moines, IA 50306-1555

Fax Number:
866-709-3922

Phone Number:
888-266-8489

Claim Forms

For claim forms, call 800-234-5514 to speak with a customer service representative.

Contact Information

Mailing Address:

PO Box 64294
St. Paul, MN 55164-0294

Fax Number:
866-860-4024

Phone Number:
800-234-5514

Claim Forms

For claim forms, call 888-266-8489 to speak with a customer service representative.

Contact Information

Mailing Address:

7700 Mills Civic Parkway
West Des Moines, IA 50266

Fax Number:
866-709-3922

Phone Number:
888-266-8489