C&J's offices will be closed Monday Sept 5th in observance of Labor Day and will reopen Sept 6 at 8 am CT.

To submit claims using the Assignment Funding Management System click the CLIENT LOGIN button at the top right of the screen and login with your username and password. Simply choose the Submit a claim option and fill out the Assignment Funding Request Form with the information of the deceased and policy information. The Document Preparation Program will then generate the documents needed to complete the claim. Simply print the documents having the beneficiary sign and complete the forms and upload or fax them to C&J.
 

Your firm not currently a client of C&J? Why Wait? Click here to submit New Account Set Up information and preferred method of payment or call us at 1.800.785.0003.
If you need additional forms feel free to browse our Forms Library below.
 

Forms for Download

Immediate Approval Fact Sheet -This form is to be used to request a case be considered for funding. This form provides the necessary information with which to start verifying coverage on the particular policy(s).(This form is not needed if claim is being submitted through the Assignment Funding Management System)

Irrevocable Assignment/Reassignment – The top portion (Assignment) of this form is to be filled out and signed by the beneficiary(s) assigning the benefits to the funeral home or cemetery. The bottom portion (Reassignment) of this form is to be filled out and signed by an authorized representative of the firm reassigning the benefits to C&J. Both signatures need to be notarized.

Claim Form Library – C&J’s claim form library consists of hundreds of specific insurance company claimant statements. Please have the beneficiary(s) complete and sign the proper insurance company claim form related to their policy. If the specific company‚Äôs form that you need is not available call our office at 800.785.0003 to see if that company requires one or if we might have one available.

Direct Funeral Home Assignment – In the event the funeral home is the named beneficiary of the insurance proceeds, the funeral home may simply complete this form in place of the Irrevocable Assignment/Reassignment form. THIS FORM IS NOT REQUIRED IF YOUR FIRM IS NOT THE NAMED BENEFICIARY IN THE POLICY.
Lost Policy Affidavit – In the event the insurance policy is lost or destroyed some insurance companies may require the beneficiary sign a Lost Policy Affidavit.

Small Estate Affidavit – If the primary beneficiary and contingent beneficiary of the policy are deceased, a small estate affidavit will need to be filled out by the surviving family. Some insurance companies require their own affidavit; other will take this generic one. Have all immediate family members sign a small estate affidavit if the beneficiaries are deceased.

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