Article Guide
The Change of Beneficiary Request form serves a critical function in ensuring that policyholders can update their beneficiaries according to their current wishes. This form must be completed during the lifetime of the insured and allows the policyowner to designate new beneficiaries for their policy. Upon the insurer’s receipt of the completed form, the changes become effective as of the date signed by the policyowner, regardless of the insured's status at that moment. However, any payments or actions taken by the insurer before the form was received may affect these changes. It is essential to note that if the new beneficiary is a trust, documentation must accompany the request. The form also stipulates that when designating multiple beneficiaries, percentages must be used rather than dollar amounts, ensuring clarity in the distribution of benefits. Additionally, the form requires detailed information about both primary and contingent beneficiaries, as well as necessary signatures. Clients can find further assistance and information by contacting the provider directly.
Form Sample
Change of Beneficiary Request Form
Beneficiary change requests can only be made during the lifetime of the insured. Upon the Insurer’s receipt of this completed form, the Beneficiary change will be effective as of the date it was signed by the Policyowner and whether or not the Insured is living when we receive it. However, the change will be subject to any payment that the Insurer may have made or actions it may have taken prior to receipt of the completed form.
Important Instructions
1.If new beneficiary is a trust, a copy of the trust document must be submitted and the trust name and date must be included as the name in the information box below.
2.If additional space is needed, please attach a separate sheet which includes: 1) the policy number and name of insured; 2) the information requested in the box below; 3) signature of Owner(s) along with the date; and 4) the signature of a Witness.
3.For multiple beneficiaries, use percentages NOT dollar amounts. If no percentages are indicated, an equal division is assumed.
Contact Information:
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Section A - Policy information (you must complete this section)
Policy Number
Insured's Name
Policyowner's Name
Section B - Primary beneficiary information
Primary – The undersigned hereby requests that all previous primary beneficiary designations and settlement options elected be revoked and makes the following designations (if no entry is made, previous designations and/or elections will remain unchanged):
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Section C - Contingent beneficiary information
Contingent (secondary) – Receives benefits ONLY if no Primary Beneficiary survives the insured. The undersigned hereby requests that all previous contingent beneficiary designations and settlement options elected be revoked and makes the following designations (if no entry is made, previous designations and/or elections will remain unchanged):
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Section D - Signatures (you must complete this section)
Signature of Policyowner (with title if applicable) |
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Policyowner's Telephone Number |
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Signature of |
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Signature of Witness (person cannot be a designated Beneficiary) |
Name of Witness (Please Print) |
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Have you...
•completed Section A and provided us with complete Policyowner information?
•provided us with complete Primary beneficiary information in Section B?
•provided us with complete Contingent beneficiary information in Section C, if applicable?
•completed Section D by providing us with all appropriate signatures and dates?
101954HL
For standard mail delivery:
The Hartford
Individual Life Division
PO Box 64582
St. Paul, MN
Page 1 of 1
(REV. 12/12)
Document Specifications
| Fact Name | Details |
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| Effective Date | The beneficiary change becomes effective on the date the Policyowner signs the form, regardless of whether the Insured is living at the time of receipt. |
| Lifetime Requirement | Requests for changes can only be made while the insured individual is alive. |
| Trust Requirements | If the new beneficiary is a trust, a copy of the trust document must be submitted along with the trust's name and date. |
| Multiple Beneficiaries | When designating multiple beneficiaries, the form requires the use of percentage allocations, rather than dollar amounts. |
| Payment Considerations | The change is subject to any payments or actions taken by the Insurer prior to the receipt of the completed form. |
| Signatures Required | Completion of Section D is mandatory, including signatures of all owners and a witness who cannot be named as a beneficiary. |
Steps to Filling Out Change Of Beneficiary Request
Once you have completed the Change Of Beneficiary Request form, it will be processed by the insurer. This means your new beneficiary designations will take effect once the form is received. Make sure to provide accurate information to avoid delays.
- Write your Policy Number, Insured's Name, and Policyowner's Name in Section A.
- In Section B, fill in the information for each primary beneficiary, including their Name, Social Security Number, Date of Birth, Relationship to Insured, Percentage, Address, City, State, Zip Code, and Phone Number. If there are multiple beneficiaries, be sure to specify the percentage for each.
- If there are contingent beneficiaries, complete Section C with their details in the same manner as Section B.
- Proceed to Section D. Sign the form as the Policyowner, providing your Telephone Number and the Date. If applicable, have a Co-owner or Second Officer sign as well.
- Ensure a witness, who is not a designated beneficiary, signs the form in Section D, and prints their name along with the date.
- Before submitting, double-check that all sections are complete, and all necessary signatures and dates are present.
- Mail the completed form to The Hartford Individual Life Division at the address provided: PO Box 64582, St. Paul, MN 55164-0582.
More About Change Of Beneficiary Request
What is the process for changing a beneficiary using the Change Of Beneficiary Request form?
To change a beneficiary, you must complete the Change Of Beneficiary Request form while the insured is still alive. Ensure that you fill out all required sections, including personal information for both the policyowner and beneficiaries. The change will take effect as soon as the form is signed by the policyowner, regardless of the insured's status at the time. It's crucial to keep in mind that if the insurer has made any payments or taken action prior to receiving the completed form, those decisions will not be altered by the submitted request.
What should I do if the new beneficiary is a trust?
If you are naming a trust as the new beneficiary, you must submit a copy of the trust document along with the request form. The trust's name and the date it was established should also be clearly indicated in the designated information box of the form. This ensures that the insurance company has all necessary details to process the change accurately.
How should I designate multiple beneficiaries on the form?
When designating multiple beneficiaries, be sure to express their shares in percentages rather than fixed dollar amounts. If you do not specify percentages, the insurer will assume that the inheritance is to be divided equally among the named beneficiaries. This simple guideline helps prevent confusion and ensures that everyone receives their intended share of the policy benefits.
What happens if I forget to include a signature or any required information?
Common mistakes
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Failing to include the trust document when designating a trust as a beneficiary. If the new beneficiary is a trust, the trust name and date must be listed in the information box. Without the trust document, the request may be invalid.
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Neglecting to provide percentages for multiple beneficiaries. If applicants use dollar amounts instead, it will lead to confusion and possible disputes. If no percentages are specified, an equal division among beneficiaries is assumed.
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Omitting necessary signatures. All required sections must be signed to validate the request. Signatures should come from the Policyowner, any co-owner, and a witness who is not a designated beneficiary.
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Leaving out essential information. Each section must be filled out completely. Failure to provide full details can delay the processing of the request or result in it being rejected altogether.
Documents used along the form
When completing a Change of Beneficiary Request form, you may also need to gather additional documents that complement your request. Each of these documents plays a crucial role in ensuring that the beneficiary changes are executed smoothly and without any oversight. Below are some common forms and documents you might encounter in conjunction with this request.
- Trust Document: If you are designating a trust as a beneficiary, you must include a copy of the trust document. This ensures that the insurance company has clear evidence of the trust’s existence and its stipulations for the benefit distribution.
- Additional Sheets for Information: Sometimes, the space in the Change of Beneficiary Request form may not be sufficient. An additional sheet can be attached if extra beneficiary information is needed. This document should contain the necessary policy details and signatures to maintain consistency with the primary request.
- Power of Attorney (POA): If someone else is submitting the Change of Beneficiary Request on your behalf, a Power of Attorney will be required. This document authorizes that individual to act on your behalf for such decisions, thereby ensuring legal compliance.
- Death Certificate: In cases where the insured has passed away prior to the processing of the Change of Beneficiary Request, a death certificate may need to be provided. This document confirms the death of the insured and assists in determining the validity of the beneficiary change.
- Previous Beneficiary Designation Form: If you are making a change to existing beneficiaries, you might need to attach a copy of the previous beneficiary designation form. This document provides historical context and ensures that the transition from old to new beneficiaries is properly documented.
By ensuring you have these documents ready alongside your Change of Beneficiary Request form, you contribute to a more efficient process and reduce potential delays. Each piece of documentation aids in crafting a clear, legally sound update to your beneficiary designations.
Similar forms
The Change of Beneficiary Request Form shares similarities with the Last Will and Testament. Both documents are essential for expressing personal wishes regarding the distribution of assets. In a Last Will and Testament, an individual can name beneficiaries who will inherit their property upon their death. Similarly, the Change of Beneficiary Request Form allows a policyowner to designate primary and contingent beneficiaries for a life insurance policy, ensuring that their intentions are honored. While one document operates after death, the other pertains to current insurance arrangements, reflecting the importance of clear beneficiary designations in estate planning.
Another document similar to the Change of Beneficiary Request Form is the Power of Attorney. This legal instrument allows an individual to appoint someone to act on their behalf in legal or financial matters. Like the beneficiary change process, it requires clear identification of parties involved and follows specific formalities. Both documents are critical in managing personal affairs, ensuring that the individual's choices are respected and carried out, whether during their lifetime in the case of the Power of Attorney or after their death when dealing with insurance beneficiaries.
The Revocation of Beneficiary Designation is also akin to the Change of Beneficiary Request Form; both serve to update or clarify beneficiary information. This document is specifically used to cancel previous beneficiary designations to ensure that the individual’s current intentions are explicitly recorded. This parallels the process of changing beneficiary information in the Change of Beneficiary Request Form, where previous designations are revoked upon submitting the new request. Both documents require careful attention to detail to ensure the intended beneficiaries receive what is desired.
Similar to these forms is the Trust Agreement. A Trust Agreement outlines how assets will be managed and distributed, much like a beneficiary designation specifies who receives benefits from a life insurance policy. When a trust is named as a beneficiary, the Change of Beneficiary Request Form should include trust details, reflecting the need for precise language and clear instructions in both cases. Trust Agreements provide additional layers of protection and management for assets, paralleling the need for careful planning in beneficiary designations.
Finally, the Beneficiary Designation Form for retirement accounts mirrors the Change of Beneficiary Request Form. Both documents allow individuals to specify who will receive benefits from financial instruments after their death. While they may pertain to different types of accounts, including retirement plans or life insurance, the purpose is the same: to help ensure that the individual’s wishes are followed. In both instances, careful completion and timely updates are essential to prevent any disputes or unintended distributions of funds.
Dos and Don'ts
When filling out the Change Of Beneficiary Request form, there are critical dos and don'ts to ensure a smooth process. Follow these guidelines to avoid any mishaps.
- Do complete Section A with accurate policy information, including the Policy Number and names.
- Do provide detailed beneficiary information in Section B, ensuring all required fields are filled out.
- Do attach a copy of the trust document if the new beneficiary is a trust.
- Don't use dollar amounts for multiple beneficiaries; percentages must be specified instead.
- Don't forget to include the signature of a witness who is not a designated beneficiary.
- Don't leave any sections blank; completeness is key to preventing delays.
- Don't assume previous beneficiary designations will automatically remain; they must be explicitly revoked.
By adhering to these points, you can effectively manage the beneficiary change process with confidence. Attention to detail is essential.
Misconceptions
Understanding the Change of Beneficiary Request form is crucial for individuals looking to update their insurance beneficiaries. However, several misconceptions often arise regarding this process. Here’s a breakdown of common misunderstandings:
- Only the Insured Can Change Beneficiaries: Many people believe that only the insured person can request a beneficiary change. In reality, the policyowner has the authority to make these changes, regardless of whether they are the insured.
- Changes Are Effective Only If the Insured Is Alive: It is a common misconception that the form is only valid if submitted while the insured is alive. The change becomes effective as of the date signed by the policyowner, regardless of the insured's status at the time of receipt.
- Trusts Cannot Be Named as Beneficiaries: Some individuals think that they cannot name a trust as a beneficiary. As long as a copy of the trust document is provided, and the trust name and date are included, trusts can indeed be designated beneficiaries.
- Only Dollar Amounts Can Be Specified: A frequent misunderstanding is the belief that beneficiaries must be assigned specified dollar amounts. Instead, beneficiaries should be assigned percentages of the benefit, ensuring clarity in the distribution.
- A Witness Is Not Necessary: There is a misconception that a witness signature is unnecessary for the process. However, the signature of a witness is required and must be from someone who is not a designated beneficiary.
- All Previous Designations Are Automatically Revoked: Some people think that simply submitting a new form will automatically revoke all previous beneficiary designations. While all prior designations are revoked upon submission, it is essential to clarify the new designations in the form.
Addressing these misconceptions can lead to more effective planning and management of insurance policies. Ensuring all forms are filled out correctly and fully can prevent future complications.
Key takeaways
Changing beneficiaries is a significant step in financial planning. To make sure your wishes are honored, follow these important guidelines when submitting the Change of Beneficiary Request form.
- Ensure that you complete the entire form accurately. All sections must be filled out, including policy and beneficiary information.
- If the new beneficiary is a trust, be prepared to submit a copy of the trust document. The trust's name and date should be listed clearly in the appropriate section.
- For multiple beneficiaries, you must indicate percentages rather than dollar amounts. If no percentages are provided, the insurer will assume the benefits are divided equally among the beneficiaries.
- Double-check that all required signatures are included. This includes the policyowner's signature and, if applicable, a co-owner or witness. Missing signatures can delay the process.
Taking these steps will help ensure a smooth and effective change in your beneficiary designations.