What to do when a Nassau Life account holder dies
Report the death to Nassau Life's Benefits Department at 1-800-814-3692
A death claim on a Nassau Life policy is filed through the Benefits Department (1-800-814-3692). Because insurance proceeds pass directly to named beneficiaries, this process is separate from probate. The required documentation and timeline vary by policy type.
Death claim process
The death claim process at Nassau Life works as follows:
Filing a claim
- Nassau's service FAQ also lists the Nassau Service Center, 1-800-541-0171, for opening a death claim
- Section A: the deceased's name, Social Security number, birthdate, date of death, cause of death, and manner of death
- Section B: the beneficiary's physical address (P.O. Box not accepted) and Social Security number, or the taxpayer identification number for a trust, estate, or corporate beneficiary
- Section C: if the policy or contract cannot be found, complete the Lost Policy/Contract Agreement on the form
- Signature section: sign in the correct capacity, with a disinterested witness signature
- An executor or administrator attaches a copy of the court appointment, a trustee attaches OL4388A, and a corporate officer includes a corporate resolution
- Life Beneficiary Statement (FG11 / FG11B) only: claims of $5 million or greater require a notarized signature (Section G)
- Annuity Beneficiary Statement (FG14 / FG14B) only: the Federal/State Income Tax Withholding Election form (OL4753), included in the PDF, is required to process the claim (Section E)
- It is a separate form from the OL4132A used during the owner's lifetime and also collects generation-skipping transfer tax information
- All trustees sign
Required Documents
- Beneficiary Statement: FG11 (life) or FG14 (annuity), one per beneficiary; FG11B or FG14B in AK, FL, KS, MN, NH and NYAll three pages, signed with a disinterested witness.
- Original certified death certificateIt must show the cause and manner of death. For a benefit of $500,000 or less, a copy of a certified death certificate may be acceptable. One is needed per claim.
- Notarized signature section (Section G), on the Life Beneficiary Statement, when the claim is $5 million or greater
- Federal/State Income Tax Withholding Election (OL4753), for an annuity claimIt is included in the annuity Beneficiary Statement PDF (Section E).
- Original policy or annuity contract, if it can be locatedNassau states failure to return it will not delay the claim. The Lost Policy/Contract Agreement on the form covers a missing policy.
- Certification and Acknowledgement of Trust Agreement (OL4388A), when a trust is the beneficiaryNassau may also require a copy of the operative trust documents.
- Copy of the court appointment, when an executor or administrator signs for an estate beneficiaryNassau's claims FAQ refers to letters testamentary, appointment papers, certificates of appointment, or letters of administration.
- Corporate resolution, when a company is the beneficiaryIt shows the titled officer's authority.
- Affidavit of Extent of Interest, when the policy is collaterally assignedThe assignee and the beneficiaries complete it, stating the assignee's interest in the proceeds.
- Copy of the primary beneficiary's death certificate, if a primary beneficiary died before the insured
Forms Nassau Life issues5
- Life Beneficiary Statement (FG11)
Completed by each beneficiary. Available to download.1
- Life Beneficiary Statement for AK, FL, KS, MN, NH and NY (FG11B)
Completed by each beneficiary. Available to download.2
- Annuity Beneficiary Statement (FG14)
Completed by each beneficiary. Available to download.3
- Annuity Beneficiary Statement for AK, FL, KS, MN, NH and NY (FG14B)
Completed by each beneficiary. Available to download.4
- Certification and Acknowledgement of Trust Agreement for Death Claim Settlement (OL4388A)
Completed by all trustees. Available to download.5
Accounts handled elsewhere3
- Nassau Life Insurance Company
Its own policies and contracts, which use the same claim forms6
- PHL Variable Insurance Company
Its own policies, which use the same claim forms; claims are paid subject to its rehabilitation moratorium limits6, 7
- Pyramid Life and Constitution Life policy line
Service or claims inquiries on a Pyramid Life or Constitution Life policy6
Phone: 1-800-999-2224
What Nassau Life's agreement and guidance say3
- How proceeds are paid
On FG11 and FG14 (most states), a beneficiary receiving $5,000 or more receives the Concierge Account unless a different choice, such as a single check, is written on the form.1, 3
On FG11B and FG14B (AK, FL, KS, MN, NH, NY), a beneficiary receiving $5,000 or more selects the Concierge Account, a payment option, or a single check, and receives a single check if nothing is selected.2, 4
The Concierge Account is part of the general account of Nassau Life Insurance Company and is not a checking or bank account. It credits daily interest at a rate that can change at any time, with no guaranteed minimum.8
Concierge Account checks must be at least $250, and no additional deposits are accepted. The account closes if the balance falls below $1,000, and it can be closed at any time by writing one check for the full balance or by calling to request liquidation.8
- Dormant and unclaimed accounts
The Concierge Account Disclosure states the account is subject to state escheat law.8
- What it says about taxes
Nassau's claims FAQ says life insurance death benefit proceeds are generally not taxable to the beneficiary, but interest paid on the proceeds is. It says all or part of annuity death proceeds may be taxable and are reported on Form 1099-R.6
Sources8
- 1.Life Beneficiary Statement (FG11)
- 2.Life Beneficiary Statement (FG11B)
- 3.Annuity Beneficiary Statement (FG14)
- 4.Annuity Beneficiary Statement (FG14B)
- 5.Certification and Acknowledgement of Trust Agreement for Death Claim Settlement (OL4388A)
- 6.How to File a Life Insurance Death Claim
- 7.Connecticut Insurance Department: PHL Variable policyholder information
- 8.Concierge Account Disclosure (HO5259)
Payment is usually made within 15 business days of receiving all requirements in good order, or sooner when required by law.
Nassau Life's Benefits Department can be reached by phone at 1-800-814-3692 for questions throughout the claims process.
Sources
Data sourced from Nassau Life primary sources (31 pages reviewed). How we research.
Nassau Life death claims support
Benefits Department
Phone
Nassau Service Center
Pyramid Life / Constitution Life Claims
Hours
Mailing address
Website
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