Accidental Death Benefit
As a surviving spouse, child or dependent, you may be eligible for a $50,000 Accidental Death Benefit from the New York State Department of Civil Service if the NYS Workers’ Compensation Board determines your loved one’s death was the result of a job-related accident. To receive this benefit, you must file a claim with the Workers’ Compensation Board District Office within two years following the date of death. More details about this benefit are available from the employer’s Personnel Office.
Accidental Death Benefit
There’s no insurance application to fill out, and no premiums to pay. There’s no cost to you.
The following links direct you to the Accidental Death Benefit certificate as well as the beneficiary form:
Accidental Death Beneficiary Form and Member Update Form ONLINE
Accidental Death Beneficiary Form and Member Update Form Download
Accidental Death Certificate (Revised 12/2017)
Please be advised that this benefit is only available to active members in good standing, and ends upon retiring.
Be sure to complete the above beneficiary form so this benefit goes to who YOU designate. This form will ensure we have your most current information in the event of an accidental death claim.
Mail your completed form to:
CSEA
Attn: Insurance Dept.
143 Washington Avenue
Albany, NY 12210
1-800-342-4146