It's easy to apply for premier accidental death insurance!

To apply

  1. Print the application form for your state
  2. Fill it out completely, including your signature
  3. Mail it to:

    Securian Financial Group, Inc.
    One Integrity Parkway
    Cleveland, OH 44143-1500

Select the application for your state of residence.


Application for residents of Colorado(pdf)
Residents of Colorado
Application for residents of Illinois(pdf)
Residents of Illinois
Application for residents of Nebraska(pdf)
Residents of Nebraska
Application for residents of other states(pdf)
Residents of Alabama, Alaska, Arizona, Arkansas, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Mississippi, Missouri, New Jersey, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin and Wyoming


NASSP premier accidental death insurance is not available in the states of Indiana, Maryland, Minnesota, Montana, Nevada, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Vermont or Washington. To learn more, please contact us.