Bereavement claim form

If you've lost someone close to you recently, you can use this form to let us know and begin your claim.

Once you've submitted this form, a member of our bereavement team will write to you and let you know what happens next. We'll need to see a copy of the death certificate as part of this process. You can email this to us as a photo or PDF (please include each page) at mailbox.estates@scottishwidows.co.uk. To avoid delays, please include the policy number in your email.

Please provide your details below, ensuring you complete all sections marked with an asterisk (*).

Person Making Claim Details:

:*

:*

:*

:*

:

:*

:*

:

:*

:*

:*

:*

Please tick to confirm happy to be contacted by

SMS
Email
Phone

Deceased Details:

:*

:*

:*

:

:
2
3
4
5

:
:
:
/ /

:

:*
:*
:*
/ /

:*

:

:*

:*

:*

It would help to speed up your claim if you were able to provide the following details

:

:

:

:

:

IMPORTANT NOTES

Data Privacy Notice

Your Data Protection is very important to us, and it is important that you understand how the personal information you give us will be used. Therefore, we strongly advise that you read our privacy notice, which you can find at www.scottishwidows.co.uk/legalprivacy or you can ask us for a copy.