Call us:
800-777-8467
FILL OUT THE ONLINE FORM
Dear Kemper Customer,
Attached below is a link to the form/s you requested. Please select “Complete Form” on the appropriate line to initiate your request. Please contact us with any questions.
These forms are for use with one or more of the following Kemper Life companies: United Insurance Company of America, The Reliable Life Insurance Company, Union National Life Insurance Company, or Mutual Savings Life Insurance Company, and for policies administered for Jackson National Life Insurance Company
SET UP AUTOMATIC PREMIUM PAYMENTS (EFT)
Complete Form
Please use this form to have your premiums automatically drafted from your checking or savings account
INITIATE A NEW CLAIM FOR CONTENTS / PROPERTY LOSS
Complete Form
Please use this form to initiate a claim for the loss of contents or property.
COMPLETE W4 FEDERAL AND STATE
Complete Form
Please use this form to complete the W4 for Federal and State Taxes.
COMPLETE MATURED ENDOWMENT NOTICE
Complete Form
Please use this form to ensure disbursemnt on Maturity Date
INITIATE A NEW CASH LOAN
Complete Form
Please use this form to request a cash loan on your policy.
INITIATE A POLICY CHANGE
Complete Form
Please use this form to make a change to your policy including beneficiary updates, ownership changes, name and/or address changes, etc.
INITIATE A NEW REPORT OF INJURY (TEXAS RESIDENTS ONLY)
Complete Form
Texas residents - please use this form to initiate an injury claim on your health insurance policy.
INITIATE A NEW REQUEST FOR WAIVER OF PREMIUM
Complete Form
Please use this form to initiate a waiver of premium claim due to disability or illness
INITIATE A CLAIMANT STATEMENT (COMPLETE A DEATH CLAIM)
Complete Form
Please use this form to submit a death claim .
