Notification of a Deceased Covered California Member
Submit a copy of one of the following documents.
- A written statement that the individual is not deceased. The statement must include:
- Statement from the individual that he or she is not deceased.
- Statement from the individual that the information provided is true and correct to the best of his or her knowledge.
- The date and the signature of the individual who was incorrectly identified as being deceased.
- If a consumer is deceased, please notify Covered California. The following documents are accepted as proof of death:
- Copy of Death Certificate.
- Bureau of Vital Statistics records.
- Widow or survivor’s benefits on the deceased individual’s Social Security number (SSN).
- Veterans Administration or military service records.
- Hospital or medical records.
- Signed funeral director’s statement.
- Indian census records.
- Newspaper death notice (obituary).
- Insurance company records.
- Social Security records.
- Institutional records.
- Veterans Administration death payment correspondence.
- Insurance company death settlement correspondence.
- Minister or clergy statement.
- Proof of executor.
- Proof of estate.
- Probate court order (or Letter of Testamentary).
- Copy of a recorded Affidavit of Death of a Joint Tenant.
- Copy of a notarized Affidavit for Collection of Personal Property.
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