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Claim Forms

• Group Life Claim Form
• Monthly Aggregate Stop Loss
• Specific Request Form
• Aggregate Request Form
• Specific Loss Eligibility Sheet
• Specific Excess Risk Payment Sheet
• Notification of Catastrophic Claim

Please return by mail, fax or email to:

BEST RE
Attention: Claim Department
PO Box 19721
Irvine, CA, 92623-9721
(877) 868-5775 business extension 152
(949) 222-1004 fax
email