Electronic signature forms

Provide Unum with your bank account information and authorize us to transfer funds on your behalf. To expedite the process, have a check on hand.

Authorize Unum to provide details about your policy to individuals or organizations you designate.

Remove dependent children from your policy or policies.

Complete this form to request cancellation of your policy or policies.

Update your primary and/or contingent beneficiaries on your policy or policies.

Request a name change on your policy or policies by completing this form. Legal documentation is required unless due to marriage or divorce.

Use this form to request changes to your policy or policies, such as a decrease in benefit amounts, request for conversion of rider to a stand-alone policy, or other changes.

Please have the caregiver complete the following form each week regarding the assistance being provided with Activities of Daily Living (ADLs) and daily functioning. Please have the caregiver sign and date the attached form.