Forms

The below forms may be helpful in assisting you with your current coverage needs. If you have any questions, please contact us at 877-285-4445.

• ACH Agreement.pdf
• Address Change Form.pdf
• Beneficiary Change Form.pdf
• Accelerated Claim Form.pdf
• Accidental Death Claim Form.pdf
• Death Claim Form.pdf
• Disability Claim Form.pdf
• Dismemberment Claim Form.pdf
• Waiver of Premium Claim Form.pdf

For claim forms, please call 1-877-285-4445.

Please mail completed forms to:

Hagan Insurance Group
PO Box 4315
Clinton, IA 52733-4315