Life Insurance Forms

Find and download the form you need. Print, complete, and sign.  Then mail or fax it to:

Vantis Life
Policy Services Dept.
200 Day Hill Road
Windsor, CT 06095

Fax 860-298-5483

Some forms can be submitted & signed electronically by clicking on e-sign below.

Questions?  Call customer service at 1-866-826-8471 

The forms are in Adobe PDF format. 

Assignment of Life Insurance Policy as Collateral  
Beneficiary Change Download e-sign
Charity Election Form Download e-sign
HIPAA Authorization Download e-sign
Policy Change Request Form Download e-sign
Premium Payment Authorization Download  
Reinstatement Request
(For all states except CA, DE, FL, ND, NY, SD)
Download  
Reinstatement Request
(For CA, DE, FL, ND, SD)
Download  
Release of Assignment Download  
Request for Certificate of Insurance/Duplicate Policy Download  
Request for Rate Reduction
(For all states except CA, DE, FL, ND, NY, SD)
Download  
Request for Rate Reduction
(For CA, DE, FL, ND, SD)
Download  
Termination Request Form Download e-sign

The following forms are specific to NY state customers:

Assignment of Life Insurance Policy as Collateral Download e-sign
Beneficiary Change Download e-sign
Charity Election Form Download  
HIPAA Authorization Download e-sign
Policy Change Request Form Download e-sign
Premium Payment Authorization Download e-sign
Reinstatement Request Download  
Release of Assignment Download  
Request for Certificate of Insurance/Duplicate Policy Download  
Request for Rate Reduction Download