To apply for a reinstatement of your policy, please have each of the forms completed for all individuals who had been covered by the policy at the time it lapsed. Upon receipt of the completed forms, we will consider your policy for reinstatement. We will notify you of the required payment amount, if the reinstatement is approved. We are not able to accept any payments on the policy until that time.

Print and complete the form, then email it to customerservice@benfinancial.com or mail it to the address shown on the form.