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File a Claim

Lafayette Life contracts experienced professional insurance agents and brokers to assist you in your policy needs, including filing claims. If a relative recently passed away and you require assistance filing an insurance claim, you can begin the process by filing a claim online using the form below or contacting the Lafayette Life Financial Representative assigned to the policy to obtain the necessary forms1 

  • W-9 form: include name, address and social security number of the beneficiary
  • Beneficiary's statement and payment direction form
  • Certified copy of the certificate of death from the health department
Required Fields*
1 There may be special circumstances in which additional documentation may be necessary. (i.e. trusts, estates, pre-deceased beneficiary, minors, and special arrangements).