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Legal and Privacy

Additional Information

These Privacy Practices are effective as of January 1, 2014. We reserve the right to modify this statement at any time and will post the current privacy statement incorporating those changes on this page. Changes to this statement are effective as of the date they are posted.

Confidentiality Provisions for Victims of Domestic Violence

New York Insurance Law section 2612 prohibits any insurer to discriminate against an individual who has been a victim of domestic Violence. Any individual or an individual under the care of another who has a policy with Jackson National of New York and is a victim of domestic violence and has obtained a valid order of protection against the policy or contract owner may contact us to provide an alternative address and/or telephone number.

To request confidentiality in accordance with the provisions of this regulation, please send us the order of protection against the policy or contract owner and complete the appropriate form:

  • For policies issued by Jackson National Life and Brooke Life Insurance Company, please use form X2612 which is available by searching for this form number in the Forms Search utility.
  • For policies issued by Jackson National Life of New York, please use form N2612 which is available by searching for this form number in the Forms Search utility.
  • For policies issued by Security Life of Denver (ING/Voya), please use form SLD2612 which is available by searching for this form number in the Forms Search utility.

Please send the completed form, along with the order of protection, to the following address:

Jackson National Life Insurance Company of NY
Attention Policy Owner Services
PO Box 30900
Lansing, MI 48909-8400

If you have any question or need to revoke the existing request, please contact us.

If you are a victim of domestic violence, you may contact the New York State Domestic and Sexual Violence Hotline at 1-800-942-6906.

Jackson® is the marketing name for Jackson National Life Insurance Company® (Home Office: Lansing, Michigan) and Jackson National Life Insurance Company of New York® (Home Office: Purchase, new York). Jackson National Life Distributors LLC.

CMC1277 07/16

© 2018. All rights reserved
Jackson National Life Insurance Company
1 Corporate Way
Lansing, MI 48951