Have a question?
+962 6 590 1040
Find a Form
Here you can find a comprehensive set of forms that will help you in making changes to your policy or in filing a claim. To download a form, just click on a link below.
The following forms are in PDF format, so please make sure you have Adobe Acrobat Reader in order to view these forms.
Select a claim form from the links below. If you need help on which form to use for your claim, visit our “Make a Claim” section. Here we have outlined the process and the documentation requirement for every type of claim.
You can use the forms provided here to amend your existing policy or to take advantage of some of your policy features. Download the appropriate form, complete and sign the same and then just fax or mail it to our Customer Service Department.
Fax us on +962 6 5930049 or send the form to
American Life Insurance Company,
Jabal Amman – Fourth circle.
Building number 91 Zahran Street
PO box 1307
Amman 11118 Jordan
- Customer Information Update - Arabic.
- Customer Information Update - English.
- Request for Policy Change - Arabic.
- Request for Policy Change - English.
- Request for a Loan on the Policy.
- Appointment of Irrevocable Beneficiary.
- Declaration and Undertaking Regarding lost Policy - Arabic.
- Declaration and Undertaking Regarding lost Policy - English
- Re-Instatement and Declaration of Health Condition.
- Application and Health Certificate - Arabic.
- Application and Health Certificate - English.
- Signatory Forms.