APVIDA Insured Death Form Format

7 minutos de lectura

This article will explain everything related to APVIDA Insured Death Form. If a person has life insurance from this institution and something happens to him, the doctor is the one who must fill out the form.

If you want life insurance in Mexico, we advise you to continue reading this article so that you can take notes.

APVIDA Insured Death Form

Family members who need to have the APVIDA Insured Death Form, they must access the web portal of the Life Patrimonial Insurance Company.

When they have entered your web page, they should go to the menu and click on format, then several options will appear. You must click on “Claims Procedures Format”.

Then several formats will appear and you will click on “Medical Questionnaire”. Directly the APVIDA Insured Death Form can be obtained in a PDF file. Plus, you’ll be able to print it as quickly as possible.

Filling out the APVIDA Insured Death Form

They must first take into account that the APVIDA Insured Death Form It must be completed by hand by the doctor who issued the death certificate or by the treating doctor of the insured person.

The form is divided into three parts and they are the following:

Insured data

The first part, the person in charge of filling it out, must provide the following information:

  • The name (paternal and maternal surname, names).
  • the Policy Number.
  • The type of insurance, whether individual, group or collective.
  • Certificate number.
  • Residence at the time of death.
  • City and State.
  • Age at death.
  • Place where the person passed away.
  • The sex of the person.
  • Date of death.
  • Highlight the day, month and year.
  • Explain the death if it occurred in the hospital or in a sanatorium.
  • Time to meet the insured?
  • Set the time to serve the insured.
  • Explain when you were first asked about the direct or indirect cause of death.
  • If you have not tried, you must answer What is the reason for issuing the death certificate?


It is important to note that, if you were assisted by having illnesses, conditions or operations, you should detail in a table in the APVIDA Insured Form the following information:

  1. The name of the disease.
  2. Highlight the number of times the person attended.
  3. Start date, with its day, month and year.
  4. Duration.
  5. Gravity.
  6. Aftermath.

In which case other doctors attended, the manager must fill in their names, their phone numbers, their addresses, city and state.

Causes of Death

In the second part of APVID Insured Death FormA, you will need to complete a table. In the first part of this table, the disease, injury or pathological state that causes death stands out. The causes, antecedent, morbid states, if any exist.

In the next line you have to explain the causes of death (only one in each line) and the last one should put the approximate interval between the onset of the disease and the death of the person.

You can see that in the box there is a second part where it highlights other significant disease states that contributed to death, but not related to the disease. As in the first part, you must explain the causes and finally the interval.

They should take into account that the causes of death must be recorded in accordance with the model of the international certificate that determines parts 1 that is the cause of death and part 2 that is other pathological states not related to the disease.

It must be stated that the information provided, She is attached to the truth, according to the elements she knows about the case.

Medical Data

Third and last part, the doctor must provide information such as: the name of the specialist, his / her address, the state, city, telephone, certificate of the specialty council, the general address of the professions card, the doctor’s card, RFC, place, the date, with its day, month and year. Finally you will have to sign the treating doctor and that’s it.

What is it for?

The APVIDA Insured Death Form it works when a sinister case happens. If the person dies and has life insurance, the doctor must complete this document to pass it on to the beneficiaries.

What is APVIDA?

The Insurer Patrimonial Vida SA (APVIDA) It was created on May 21, 2004 and acts as an Insurance Institution in accordance with the LISF, in force since April 4, 2015. In addition to being prepared for the life insurance operation.


The APVIDA is an institution in charge of life insurance, which provides patrimonial protection to the insured and his family in order to promote financial security in the event of contingencies.


APVIDA wants to be recognized as a life insurance institution, which has innovated every year, to show its clients that they can trust it, both financially and sustainably.


APVIDA they behave ethically and loyally in everything they do. They are also dedicated to establishing fraternal relationships, in solidarity with those who need it.

They perform their duties responsibly and consistently in fulfilling their commitments. In addition, they provide their insurers with innovative services, thinking about their financial protection.

Service Model

  • The APVIDA develops plans tailored to the needs of citizens.
  • Delivery of quotes in at least 48 hours.
  • Claims payment in one time maximum of 10 days, from the moment you receive the complete documents from the person.
  • Issuance of policies in the next 48 hours.
  • If the customer needs to contact APVIDA, the company has a customer service line that is 01 (55) 4161-9550 or your email atensionclientesiniestro@apvida.mx.

What is the APVIDA Insured Death Form?

The APVIDA Insured Form is a document that must be issued by the doctor who issued the death certificate or by the treating doctor of the deceased, which contains the insured’s data.

How should APVIDA life insurance be charged?

When the insured must obtain the benefits that correspond to having his life insurance, the necessary documents are the following:

Collect life insurance in case you have died

If the citizen must collect life insurance in the event of death, he must comply with the following documentation:

  • You must have the claim application from the insured. Has to be filled out and signedIn addition, the format allows adding maximum to 4 people on the same page.
  • the death certificate.
  • The birth certificate of the beneficiaries and the insured.
  • The CURP of each beneficiary and the insured.
  • You must attach the official identifications of the beneficiary and the insured.
  • Medical history.
  • Medic report.
  • Original policy.

In the event that the person has died in an accident, the number of the record of the Public Ministry must be indicated and a certified photocopy of the same must be provided. You must also attach a necropsy result, alcohol toxicology analysis.

The documentation that the beneficiary or beneficiaries must bring are the following:

  • A original copy of the birth certificate of each of the beneficiary citizens, no more than one year.
  • Photocopy of your identification document from each of them. It can be a voter’s credential, passport or your professional identity card.
  • Proof of your address of each person who is going to benefit. The voucher cannot be more than three months old.
  • RFC with its homoclave and CURP of each of them.
  • The marriage certificate in which case the citizen is a spouse.

If you don’t know what to do in the event of a claim, you should first contact your insurance agent or claims executive at 4161-9561. For attention and follow-up you can communicate through the following email atencionclientesiniestros@apvida.mx, from Monday to Thursday, froms 9:00 a.m. to 2:00 p.m. and 3:30 p.m. to 6:00 p.m. Friday from 9:00 a.m. to 4:00 p.m.


All the documentation that is in copy, will have to come with the following legend “collated against original, attaching the full name, date and signature of whoever collates”.

Finally, it is important that people obtain life insurance for any eventualities that may arise in their life. This institution is ideal to obtain it.

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