Forms

Forms for Life Insurance Contract Holders


Forms You May Need


click on any of the links below to download a form. Then just fill it out and mail it to John Hancock, as instructed on the form.

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Change of Address Information
Request to Use Policy Values to Pay Premiums
Request to Use Policy Values to Pay Premiums

Use this form to pay your premium due using your policy's dividend or cash value.

Download Automatic premium loan election for life insurance Form (PDF)
Change of Beneficiary

Use this form to change the beneficiary election on your life insurance policy.

Download Change of Beneficiary Form (PDF)
Change of Ownership (absolute assignment)

Use this form to change the ownership of your life insurance policy.

Download Change of Ownership absolute assignment (PDF)
Claim Form: If you reside in AR, AZ, CO, FL, KS, MD, NC, ND, NV and VT

Use this form to claim the benefit of a life insurance policy if the insured or a covered person under the rider provision has passed away if you reside in one of the state's listed.

Mail completed claim form to:
Life Claim Services, John Hancock Life Insurance
Suite 1101, 1 John Hancock Way
Boston, MA 02217-1099

Download Claim Form: If you reside in AR, AZ, CO, FL, KS, MD, NC, ND, NV and VT Form (PDF)
Claim Form: For all other states

Use this form to claim the benefit of a life insurance policy if the insured or a covered person under the rider provision has passed away.

Mail completed claim form to:
Life Claim Services, John Hancock Life Insurance
Suite 1101, 1 John Hancock Way
Boston, MA 02217-1099

Download Claim Form: For all other states (PDF)
Collateral Assignment / Release of Assignment

Use this form to collaterally assign your life insurance policy.

Download Collateral Assignment / Release of Assignment Form (PDF)
Request for Name Change

Use this form to update the name of the existing owner, payor, beneficiary, insured, or person on rider. Please use Ownership Change form if you wish to transfer ownership.

Download Name Change Form (PDF)
Investment Option Change (Form PS5110US)

Use this form to change the investment options within your life insurance policy if you have a FlexV, MVL, or VLI policy.

Download Request for Investment Option Change (Form PS5110US) Form (PDF)
Investment Option Change (Form PS5108US)

Use this form to change the investment options within your life insurance policy if you have a Medallion Executive Variable, Medallion Variable Universal, Performance Executive Variable Universal, Performance Survivorship Variable Universal, or a Variable Estate Protection policy.

Download Request for Investment Option Change (Form PS5108US) Form (PDF)
Investment Option Change (Form PS5109US)

Use this form to change the investment options within your life insurance policy if you have an Accumulation, Corporate VUL, EPVUL, Protection, SPVL, Survivorship VUL, VUL, VUL Accumulator, or VUL Protector.

Download Request for Investment Option Change (Form PS5109US) Form (PDF)
Request for Dividend Withdrawal
Request for Dividend Withdrawal

Use this form to withdraw your dividends from your life insurance policy.

Download Request for Dividend Withdrawal Form (PDF)
Request for Policy Loan

Use this form to take a loan from your life insurance policy.

Download Request for Policy Loan Form (PDF)
Request for Policy Surrender

Use this form to surrender/cancel your life insurance policy.
Policy Surrender Settlement Flyer

Download Request for Policy Surrender Form (PDF)
Request for Pre-Authorized Payment Plan

Use this form to set up or change your automatic deduction from your bank account that is used to pay your life insurance premiums.

Download Request for Pre-Authorized Payment Plan Form (PDF)
Request for Partial Withdrawal/Partial Surrender/Excess Value

Use this form to request a partial withdrawal from your MVL or VEP life policy. This form is also used to withdraw the excess value from your FlexV life policy.

Download Request for partial withdrawal Form (PDF)
Special Authorization Form

Use this form to add authorization for a third party to obtain information about your life insurance policy.

Download Special authorization form Form (PDF)
Statement of Lost Policy
Statement of Lost Policy

Use this form to request a duplicate life insurance policy if your policy was issued after 1965.

Download Statement of Lost Policy Form (PDF)
Statement of Lost Policy
Policy Change Form No Underwriting Required

Use this form to request inforce policy changes that do not require underwriting approval.

Download Statement of Lost Policy Form (PDF)

Guaranteed product features are dependent upon minimum premium requirements and the claims-paying ability of the life insurance company issuing the life insurance contract.

Whole Life Insurance, Term Insurance, Universal Life Insurance:

Insurance products are issued by: John Hancock Life Insurance Company (U.S.A.), Boston, MA 02116 (not licensed in New York) and John Hancock Life Insurance Company of New York, Valhalla, NY 10595.

Insurance policies and/or associated riders and features may not be available in all states.

Variable Life Insurance:

Insurance products are issued by: John Hancock Life Insurance Company (U.S.A.), Boston, MA 02116 (not licensed in New York) and John Hancock Life Insurance Company of New York, Valhalla, NY 10595 and securities offered through John Hancock Distributors LLC through other broker/dealers that have a selling agreement with John Hancock Distributors LLC, 197 Clarendon Street, Boston, MA 02116.

Insurance policies and/or associated riders and features may not be available in all states. Some riders may have additional fees and expenses associated with them. Refer to the product prospectus for additional information.

Variable universal life insurance has annual fees and expenses associated with it in addition to life insurance related charges (which differ with the product chosen), including surrender charges and investment management fees. Variable universal life insurance products are long-term contracts and are sold by prospectus. They are subject to market risk due to the underlying sub-accounts, and are unsuitable as a short term savings vehicle. The primary purpose of variable universal life insurance is to provide lifetime protection against economic loss due to the death of the insured person. Cash values are not guaranteed if the client is invested in the investment accounts. There are risks associated with each investment option, and the policy may lose value.