Effective Immediately: Changes to Life Applications and HIPAA Forms

To provide a better customer and agent experience, Protective has updated the paper life insurance application form, PL-400. These changes provide a cleaner layout making it easier to complete the forms. 

Additionally, Protective has updated the HIPAA form to be more specific regarding the types of data that may be collected during the application process.

These form changes took effect on February 1, 2022.

For paper applications, the old versions of these forms were honored through May 1, 2022. The new versions are now required going forward.

For ticket/TeleLife applications, Protective will honor the forms included in application packet regardless of when the application is signed.

The new forms have been added to MyProtective.com for your convenience. Going forward, please be sure to discard any saved forms that may be outdated.

If you have any questions about changes to these forms, contact your Protective representative.