Workplace Death Notification | Retirements

Workplace Pension - Notification of the death of a customer

We understand that this is a difficult time for you, so to make it as easy as possible for you to notify us that one of our customers has passed away you can fill in this form.

By providing us with as much information as possible here we can quickly make a decision as to who the beneficiaries of the pension benefits are and get in contact to make the payment as soon as we can.

We will ask you to upload any certificates relevant to the policy and the information you provide so if you have these to hand before you begin the form you will find it quicker to complete.

If you do not have all of the information or certificates available, we can still review the information you submit and will get in touch to let you know if there is anything we need in order to progress to payment.

Please ensure you provide your contact details so that we can contact you should there be any issues with the form.

If you would like to contact us, you can call us between 9am and 5pm Monday to Friday on:

0370 060 0402

* Mandatory

Information on the Deceased

Pension Policy No:

Name of Member's Employer who set this policy up for them

Member's National Insurance number

Title

Full Name *

Address *

Post Code *

Date of Birth *

Registration of Death

For the following question, please pick 'Yes' if you have either a full or interim death certificate or a coroner's report. If you select 'Yes' and you have it available please upload an image of it to support our investigations. If it is unavailable we may contact you for this information prior to settling the claim.

Do you have a Death Certificate? *

Please upload the certificate here

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Date of death *

Did the deceased leave a Will? *

Please upload a copy of the will here

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Your Details as Notifier of the Death

Title

Full Name *

Date of Birth *

Relationship to Member *

Relationship to Member - other

Address *

Phone No *

Email Address

Preferred contact method? Please make sure you've provided us with the relevant contact details above *

Next of Kin Details

Next of Kin (NOK) is the term used to describe your closest living relative, such as your spouse or civil partner, children or parents etc . Please provide the details of the member's closest living relative.

The information you provide will help the trustees of the scheme make a decision as to whom the benefits should be payable to. We may look to contact you or any of the people detailed in this form to help us make the right decision.

Same as Notifier?

Title

Full Name *

Address *

Date of Birth

Relationship to Member *

Relationship to Member - other

Email address *

Postal address *

Phone Number

Preferred contact method?

Financial dependency is classed as anyone who relied on the member financially for things such as money, clothes, food, bills or who was mutually reliant such as shared rent/mortgage/bills etc. This can also include the member's minor children or children over the age of 18 who receive regular financial support, or anyone that is worse off without the member or in financial trouble.

Are there any people we should take into consideration for this claim who were financially dependent on the member and haven't already been mentioned in this form?

Full Name

Address

Date of Birth

Contact Number

Email Address

Please upload proof of Financial Dependency here. This could be proof of shared household bills, a shared Tenancy Agreement, a shared mortgage statement, shared Council Tax statements or a bank statement showing regular payments from the Member.

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Someone who has a legal claim on the late member's pension would be someone such as a current or spouse or civil partner or a previous spouse or civil partner with a pension sharing order.

Is there anyone else we should consider who has a legal claim on this pension who hasn't already been mentioned on this form (such as current or previous spouse or civil partner, children, parents).

Full Name

Address

Date of Birth

Contact Number

Email Address

Please upload legal claim evidence

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Has the Member ever been divorced or had a civil partnership dissolved? *

If Member was not married or in a civil partnership at time of death or there was no pension sharing order in place, please upload decree absolute here

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Please add any additional comments you wish to make that might help us with this claim.

We may look to contact you or any of the people detailed in this form to help us make the right decision. Once the trustees have made their decision we will contact the relevant parties to confirm the amount payable and how they would like the claim paid.

If required, we will endeavour to contact you via your preferred contact method, but there may be times where we need to use an alternative contact method.

Declaration - By submitting this form you confirm the information included is true and accurate to the best of your knowledge and confirm that you have not omitted any material facts that might influence the Scheme Trustee / Administrator in reaching their final decision. You promise to notify Legal & General if you discover that you have made false or incomplete statements.

Would you like to receive updates on the progress of this claim via text message:

Yes (please provide mobile number below)

Mobile number

If you wish to contact us to check the progress of your claim or provide any further information our e-mail is: Pensions.SensitiveClaims@landg.com