When individuals find themselves needing to update their personal information with an insurance company, the process often involves completing specific forms to ensure that all records remain accurate and up to date. The Bankers Life And Casualty form serves this exact purpose for clients wishing to change their registered address. This document outlines a straightforward protocol, requiring policyholders or their legal representatives to submit a written request to officially modify their address of record. It emphasizes the necessity for such updates to be conveyed in writing, underscoring the importance of clear, documented communication in managing policy information. A remarkable element of this process is the estimated timeframe of 30 days to process the address change, a detail that highlights the operational complexity behind seemingly simple administrative adjustments. Additionally, the form provides space for essential information, including the policyholder's name, claimant's name, and policy numbers, which underscores the personalized and secure approach to policy management. Importantly, the submission of this form affects how policyholders receive vital correspondence from the insurer, such as premium statements, claim checks, and explanations of benefits, thereby ensuring that the insurance services continue without disruption. Moreover, the form stipulates the need for a proper signature and, where applicable, a legal representative's documentation, without which the request is invalidated. This requirement serves as a safeguard, ensuring that changes are authorized and protect the policyholder's privacy and security. Lastly, for those requiring assistance, it provides contact details for customer service, further improving accessibility and support for policyholders navigating through their policy management tasks.
| Question | Answer |
|---|---|
| Form Name | Bankers Life And Casualty Form |
| Form Length | 1 pages |
| Fillable? | Yes |
| Fillable fields | 14 |
| Avg. time to fill out | 3 min 3 sec |
| Other names | bankers life com proof of residency, bankers life proof of residence form, continued monthly residence form, bankers life and casualty change of beneficiary form |
www.bankers.com |
ADDRESS CHANGE REQUEST |
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All address change requests must be submitted in writing. Use this form to request a permanent change of address. Please allow 30 days for the address change to be processed.
Policyholder’s Name: ____________________________________________
Claimant’s Name: ____________________________________________
Policy Number(s):
____________________________________________ __________________________________________
____________________________________________ __________________________________________
PLEASE CHANGE MY ADDRESS TO:
Address: ____________________________________________________________________________________
City: ___________________________________ State ____________________ Zip code ________________
Effective Date of Change:_____________________________________________
(This address change will remain in effect until further written notification is received.)
Name of person completing this form (please print): ___________________________________________
_________________________________________________ |
_______________________________________ |
Signature of Policyholder (or Legal Representative) |
Date Signed (Month/Date/Year) |
_________________________________________________ |
_______________________________________ |
Policyholder (or Legal Representative) Name (Please Print) |
Signed at (City/County/State) |
_________________________________________________
If Legal Representative, give relationship to Policyholder
(Attach a copy of your legal authority, Power Of Attorney, guardianship, etc. if applicable)
PLEASE NOTE:
This address change will affect all correspondence being sent to the policyholder by Bankers, such as: Premium Statement, Claim Checks, Explanation of Benefits (EOB).
This form must be signed and dated by the policyholder or Legal Representative in order to be considered valid. Without proper signature(s) or documentation, this document is null and void.
If you have further questions please feel free to contact our Customer Service Department at
Please mail Address Change Request Form to:
Policy Benefits Department
PO Box 1902
Carmel, IN
Or
Fax to:
18895 |
(8/12) |
Copyright © 2012 Bankers Life and Casualty Company. Chicago, IL All Rights Reserved.