Try for free

Mutual of Omaha 463348 Living Benefits Claim

United of Omaha Life Insurance Company, part of Mutual of Omaha, uses this 6-page packet when a group life insured with a terminal condition asks for part of the death benefit early. The attending physician completes the Statement of Terminal Condition, covering history, present condition, diagnosis, treatment, prognosis and mental competence. The beneficiary must consent, because the death benefit is reduced by the amount paid.

Who completes it

The attending physician completes the 1-page Attending Physician's Statement of Terminal Condition. The insured completes the claim statement and authorization, the beneficiary signs the Consent Beneficiary Form, and the master policyholder or group administrator completes the employer section.

Submitting and payment

How to submit it
The insured returns the physician statement together with the Consenting Beneficiary Form to Group Life Claims at United of Omaha, by email, fax or mail using the contacts printed on the form.
Who pays
The physician statement states that the patient is responsible for its completion without expense to the company.

Good to know

  • Item 6 asks whether the condition is terminal, meaning expected to result in death with no reasonable prospect of recovery, and for expected survival of 6, 12 or 24 months.
  • Attach office notes for the treatment period, test results showing objective findings, hospital discharge summaries and consulting physician reports.
  • The statement asks whether the patient is ambulatory, bed confined, house confined or hospital confined, and whether they are competent to endorse checks and direct the proceeds.
  • Mutual of Omaha posts a Spanish edition of form 463348 alongside the English version on its support forms page.

Get the official form

Download the current version from the source each time; forms change without notice.

Statement of Claim for Living Benefits (Attending Physicians' Statement of Condition)

Official pagePDFVersión en español

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

What survival estimate does the Mutual of Omaha physician statement ask for?

Item 6 asks whether the injury or sickness is terminal, meaning expected to result in death with no reasonable prospect of recovery. If yes, mark expected survival of 6, 12 or 24 months; if no, give expected survival in months. You also list current treatment and any consultants seen.

Why does the beneficiary have to sign the living benefits claim?

The required disclosure explains that the life insurance death benefit is reduced by the accelerated amount paid, and the insured's request states that the beneficiary's consent is required. In community property states, the spouse must also consent. The beneficiary completes the Consent Beneficiary Form before the claim is filed.

Is the Mutual of Omaha living benefits form available in Spanish?

Yes. Mutual of Omaha posts a Spanish edition of form 463348 next to the English version on its support forms page. The English packet runs 6 pages and includes the physician's statement, the beneficiary consent and a direct deposit authorization.