Group Life Insurance Scheme Claim Form

Retrieve Claim

Please enter the required details in order to retrieve your claim:

Reference number

Please enter the claim reference number.

Scheme Number

Please enter a scheme number.

Employee's surname

Please enter employee's surname.

Employee's date of birth

(dd/mm/yyyy)

Please enter employee's date of birth in dd/mm/yyyy format.

Claim Type

Lump Sum Dependants Pension Lump Sum & Dependants Pension Member Flex Lump Sum Member Flex Dependants Pension Member Flex Lump Sum & Dependants Pension Spouse/Partner Flex Lump Sum Police, Fire and Rescue

Please select a claim type.

Police, Fire and Rescue Claim Details

Is your claim in relation to a:

Partner Claim Dependant Child Claim Member Life Insurance Claim

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Bereavement Helpline Leaflet

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Aviva Life & Pensions UK Limited.Registered in England Number 3253947.Wellington Row,York,YO90 1WR.
Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Firm reference number 185896.

© 2015 Aviva