Term Conversion Tips

Applying for a term conversion? The National Life Group website contains all the forms needed for a requested term conversion.

All conversion requests should be sent to ContractChange@nationallife.com or faxed to 802-229-3131.

The Term Conversion Kit (20007 Kit) on the website contains all the forms that may be needed for a term conversion. To apply for a term conversion the following requirements are needed:

  • Term Conversion Application form 20007
    • Complete Part A – for partial conversions be sure to complete Part A #6 with instructions on what to do with the remainder of the term policy/rider
    • Part B: note if riders are being requested that are no on the term policy you will need to complete the Policy Change/Term Conversion Supplement to the Application form 20114 and HIPPA
    • Part C: If Owner is Insured leave blank otherwise check present arrangement reaffirmed or include form 1492 for new owner
    • Part D, F , I & K must be completed
    • Part E only if applicable
    • Part G: #1 & #2 must be completed
      • If the initial premium is to be drafted immediately upon issue of the policy, be sure to leave the draft date selected blank on #2 and include banking information and signature of depositor.
      • If the client wishes to have a different draft day for the reoccurring draft, please mention this in the Remarks Section of the application.
    • Interest Crediting Strategies Form (if new policy is IUL)
    • Illustration (signed if applicable)
    • Agent Report form 1441G please include any specific suffix information or splits between agents or agencies

Did You Know?

  • If ABRs are not on the term policy but the client wants ABRs on new policy, collect the following:
    • ABR Disclosure Statements (in CA any state specific forms for ABR)
    • Policy Change/Term Conversion Supplement to the Application form 20114
    • HIPPA 8164
  • If term policy is less than two years old, ALL delivery requirements for the term must be signed and returned to the Montpelier office with the conversion paperwork.
  • Check for initial premium unless you indicate in Part G that initial premium is to be drafted immediately upon issue of the new policy. Please note** If the issue date for the new policy is being backdated for any reason, the initial premium is recommended to be in the form of cash with the application. Please make sure to provide a copy of the check upon submitting of the term conversion request.
  • If underwriting is required, the following additional paperwork is needed depending on the change being considered:
    • Class Change, Rating Removal/Reduction, Increase: Policy Change/Term Conversion Supplement to the Application Form 20114, HIPAA Compliant Authorization Form 8164 & HIV Consent Form 1443.  Please contact the Home Office for Medical Requirements if applicable.
    • Additional ABRs: Policy Change/Term Conversion Supplement to the Application Form 20114, HIPAA Compliant Authorization Form 8164 & Applicable ABR Disclosure Forms
    • Other Insured Rider or Term Rider (applicable for whole life policies): Policy Change/Term Conversion Supplement to the Application Form 20114, HIPAA Compliant Authorization Form 8164 & HIV Consent Form 1443.  Please contact the Home Office for Medical Requirements if applicable.
    • All Other Additional Riders: Policy Change/Term Conversion Supplement to the Application Form 20114 & HIPAA Compliant Authorization Form 8164.