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Bereavement information form

Bereavement

Our bereavement hub offers you supportive and practical guides that cover a range of topics from making a will to what to do when someone dies.

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Information you'll need to fill out this form

  • The name of the person who died and their last known address
  • Their date of birth if you know it
  • Policy number (s) - not essential but it will help us locate any policies they held with us
  • We will need you to upload an image of the death certificate
  • The date of death
  • If a will has been left, please upload in section 5
  • Their National Insurance Number - can be found on items such as pay slips or HMRC letters.

We'll need your contact details (name and daytime contact number) so that we can reach you again if we need any further information to process the claim. There may be additional information we need - but we'll let you know when we walk you through the process step by step.

The bereavement information form plays a crucial role in ensuring that the proceeds of a policy reach the intended beneficiary/ies. It allows us to gather essential details about the policy holder's family and circumstances, enabling us to determine if any nominations made are still valid. In the absence of a nominated beneficiary, the bereavement information form becomes the primary tool for identifying the rightful recipient/s of the policy benefits.

If you leave some fields blank, we can't assume that means the information isn't applicable. So it is better to state 'N/A', meaning not applicable, against any information that does not apply.

 

 

Let us know about a death online

* Indicates a required field

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1. Information about the person who died

Personal information
Their title *
Please use the format DD/MM/YYYY
The date of death stated on the death certificate. Please use the format DD/MM/YYYY
Last known address for the deceased
Do you know the policy number relating to the person who died? *

2. Your details

Personal information collected on this form will be used to administer your request. To understand the detail of how we use your information you can read the privacy policy (opens in new window) or listen on 0800 085 8352.

Personal information
Title *
Address
Contact details
We may use this email address to send you updates about your claim.
Preferred method of contact *

3. Required information

As Royal London are the Scheme Administrator, we have discretion as to who the death benefits are paid to. This means, as well as considering any relevant information we hold on our records, such as a nominated beneficiary, it is our responsibility to gather as much relevant information as possible regarding the policyholder’s circumstances.

Was the policyholder legally married? *
Please use the format DD/MM/YYYY
Were they financially dependent on the policyholder? *
Did the policyholder have a co-habiting partner? *
Please use the format DD/MM/YYYY
Were they (the co-habiting partner) financially dependent on the policyholder? *
Did the policyholder have any children? * Please note that ‘children’ includes 18+/adult children
Please use the form DD/MM/YYYY
Were they (the first child) financially dependent on the policyholder? *
Please use the form DD/MM/YYYY
Were they (the second child) financially dependent on the policyholder?
Please use the form DD/MM/YYYY
Were they (the third child) financially dependent on the policyholder?
Please use the form DD/MM/YYYY
Were they (the fourth child) financially dependent on the policyholder?
Please use the form DD/MM/YYYY
Were they (the fifth child) financially dependent on the policyholder?
Was the policyholder survived by their parents? *
Please use the form DD/MM/YYYY
Were they (parent 1) financially dependent on the policyholder? *
Please use the form DD/MM/YYYY
Were they (parent 2) financially dependent on the policyholder?
Was the policyholder survived by any siblings? *
Please use the format DD/MM/YYYY
Were they (sibling 1) financially dependent on the policyholder? *
Please use the format DD/MM/YYYY
Were they (sibling 2) financially dependent on the policyholder?
Please use the format DD/MM/YYYY
Were they (sibling 3) financially dependent on the policyholder?
Please use the format DD/MM/YYYY
Were they (sibling 4) financially dependent on the policyholder?
Please use the format DD/MM/YYYY
Were they (sibling 5) financially dependent on the policyholder?
Are there any other potential beneficiaries we need to consider?* This means being financially reliant upon the policyholder. For example, sharing utility bills, or a dependent child. If, you have indicated that any of the individuals named above were financially dependent on the policyholder, please provide evidence of this. For example, joint bank account statements, joint utility bills, joint rent agreement etc. Any other forms of evidence that you choose to submit will be reviewed. Evidence is not required from a husband or wife, as they are automatically deemed as a financial dependent.
State evidence can be uploaded in section 5

4. Additional information

5. Document upload

Please upload Death Certificate or any other supporting documents. If there is anyone who is financially dependant, who isn’t the spouse, please provide evidence of this such as joint bank account statements, joint rent agreement, joint utility bill etc. These documents need to be dated within the last 12 months.

 

And/or any other supporting documentation such as the will.
One to verify the name and Date of Birth and one to verify the dependent’s current address. Please note, a birth certificate can only be accepted in the case of a dependent under the age of 16 with no other ID. You can upload multiple files at the same time

6. Declaration

This is the legal part of the form, which creates a binding agreement between you and Royal London. Please read it carefully and make sure that you understand it before signing below. If there is anything that you don’t understand, we recommend that you speak to a professional adviser for advice.

We will/I confirm that I am/We are the person(s) best placed to provide the information necessary for Royal London to make an informed decision as to whom benefits are to be paid.

I/We have considered the answers that I/we have given carefully and as far as I am/we are aware, the information provided on this form is an accurate account of the policyholder’s circumstances at the date of death. I/we ask that Royal London take this into account when exercising their discretion as to whom the benefits are paid.not be in a position to send an Options pack until we have the full Death Certificate or the reason for death confirmed by the Coroners)

7. Keeping you safe from theft and identity fraud

In order to protect our customers we may have to verify your identity or the identity of certain individuals connected to a policy. At Royal London we do this electronically to make things easier for you.

If you would prefer we didn’t do this electronically, please tick the following check box. If you choose to opt out, we’ll need to contact you to request paper based evidence of your identity.

* Indicates a required field