Note: All forms are Adobe Acrobat Portable Document Files (PDFs). Click on the Adobe icon to receive the latest Acrobat Reader for free.
For all individual life death claims, we must have an original or certified death certificate.
Individual Life Death Claim Forms
Assignment of Life Insurance Proceeds
Waiver of Premium for Disability Claim Forms
The Individual Claim Department may be contacted directly at:
- Security Mutual Life Insurance Company of New York
- Attn: Individual Claims
- P.O. Box 1625
100 Court Street
Binghamton, NY 13902-1625