Assurity Life Insurance Company
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Address: |
Assurity Life Insurance Company |
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P.O. Box 82533 |
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Lincoln, NE 68501-2533 |
Assurity Life Insurance Company of New York
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Address: |
Assurity Life Insurance Company of New York Administrative Office |
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P.O. Box 82533 |
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Lincoln, NE 68501-2533 |
New Business Contact Center
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Phone: |
(800) 276-7619, Ext. 4264 for Assurity Life Insurance Company |
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(844) 401-7585, Ext. 4264 for Assurity Life Insurance Company of New York |
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Hours: |
7:00 a.m. to 5:00 p.m. Central Time |
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Email: |
underwriting@assurity.com |
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Fax: |
(402) 437-4606 |
Client Services Contact Center
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Phone: |
(800) 869-0355, Ext. 4279 for Assurity Life Insurance Company |
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(844) 401-7585, Ext. 4279 for Assurity Life Insurance Company of New York |
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Hours: |
7:00 a.m. to 5:00 p.m. Central Time |
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Email: |
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Fax: |
(888) 255-2060 |
Claims Contact Center
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Phone: |
(800) 869-0355, Ext. 4484 for Assurity Life Insurance Company |
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(844) 401-7585, Ext. 4484 for Assurity Life Insurance Company of New York |
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Hours: |
7:00 a.m. to 5:00 p.m. Central Time |
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Email: |
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Fax: |
(800) 869-0368 |
The following forms can be found on AssureLINK at https://assurelink.assurity.com in the Product Center for each product by selecting the Applications/Forms option on the left.
•Application
•Application for Changes to Health Policy
o Form No. 75-611-02255 for Assurity Life Insurance Company
o Form No. 80-611-02255 NY for Assurity Life Insurance Company of New York
•Application for Reinstatement
o Form No. 75-851-05055 (R11-12) for Assurity Life Insurance Company
o Form No. 80-853-05055 NY for Assurity Life Insurance Company of New York
•Authorization for List Bill
o Form No. 75-060-05055 (R10-15)
•Automatic Bank Payment
o Form No. 18-051-05055 (R04-14)
•Change of Beneficiary
o Form No. 18-612-05055 (R06-16)
•Evidence of Insurability
o Form No. 75-859-05051 (R11-12) for Assurity Life Insurance Company
o Form No. 80-859-05051 NY for Assurity Life Insurance Company of New York