Bereavement Support

Losing a loved one is difficult, so we want to make transferring, cancelling or updating their COTA Insurance as simple as possible. If you are a customer or representative of a deceased customer, you may complete this COTA Insurance Bereavement form to inform us of a claim, cancel or change ownership of a policy.

Download the COTA Insurance Bereavement form here and send it to us by mail or email and we will contact you to make sure everything is in order.

Return the form to us by:

Mail: COTA Insurance, GPO Box 1127, Adelaide, SA 5001

Email: [email protected] with ‘Bereavement Support’ in the subject line.

How to complete the form

Please complete all relevant sections in this form. If you require additional information on the insurance that is in the name of the deceased, please contact us on 1300 1300 50.

For each relevant insurance, select if you want to transfer the service into the name of another person or cancel the insurance. By completing and returning this form, you are authorising a COTA Insurance representative to contact you to discuss these actions and any further details or requirements such as unoccupancy of a house.

Include copies of the following documents, where applicable:

• Death certificate
• Will or probate
• Letter from Executor/Administrator
• A letter from the solicitor
• Letters of administration

Part A – Who can be a representative of a deceased estate?

To prevent fraudulent activity and privacy breaches, only people who are authorised to act on behalf of the deceased customer can access and change that customer’s insurance. Representatives are required to provide a copy of the death certificate, they must state that they’re authorised to act on behalf of the deceased customer. The people with the following relationship to the Deceased Estate will be accepted by us to act as their representative:

• An Executor, Administrator or Trustee of the deceased’s estate
• A lawyer or solicitor administering the will
• An authorised representative listed on the account

Part B – Cancellation of a service

Please complete this section by specifying the insurance(s) to be cancelled. Please note that once a policy has been cancelled it cannot be reinstated.

Part C – Change of ownership

Please complete the change of ownership section by specifiying the insurance(s) to be transferred. A new policy will be required for all transfers of insurance. A consultant will contact you to arrange the transfer.