Death Claims
Remember to complete any applicable Administrator or Employer section(s) before distributing forms to beneficiaries.
Frequently Asked Questions for Death Claims
To submit a claim, you need to distribute the following forms to EACH beneficiary:
- Claim form
- ING Personal Transition Account Supplemental Contract (not applicable for beneficiaries residing in Alaska, Illinois, Kansas, North Carolina or Nevada)
- If a Trust is named as the beneficiary, the Trust Verification form must be completed by the trustee of the trust.
| Forms for Association Group Term Life, PAI and Individual YRT | Form Number |
|---|---|
159972(1/12) | |
159818(6/12) | |
126266(5/12) | |
Claim form for beneficiaries residing in Alaska, Illinois, Kansas, North Carolina, or Nevada | 159817(1/12) |
115701(1/12) |
| Trust Verification | Form Number |
|---|---|
142020 |
Employee Benefits insurance products and services in the U.S. are provided by ReliaStar Life Insurance Company (Minneapolis, MN) and ReliaStar Life Insurance Company of New York (Woodbury, NY). Within the State of New York, only ReliaStar Life Insurance Company of New York is admitted, and its products issued. Both are members of the ING family of companies. Product availability and specific provisions may vary by state. Each insurer is solely responsible for the financial obligations under the policies or contracts it issues.



