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Fill out a RS form 1099 LTC the IRS Form 1099-c is given by an insurance company or viatical settlement provider for umber sment smade under a long-term care insurance contract or for accelerated death benefits the long-term care insurance contract is given to a person who has been officially certified as chronically ill by a licensed medical practitioner this means that the insurance company or viatical settlement provider pays for the accelerated death benefits of the chronically ill individual as certified by the licensed healthcare practitioner the amounts received from under from a long-term care insurance are normally excluded from the individuals income if payments are given on a per diem basis there may be a limited exclusion from the amount payments made for the accelerated death benefits are completely excluded from the individual's income assuming that he has been certified as terminally ill by a licensed physician for chronically ill individuals the accelerated death benefits paid are excluded to the same degree as they were paid on a long-term care insurance contract here's how to fill out an IRS form 1099 LTC you may order your official IRS forms from the IRS online ordering website or from 1-800 tax form make sure to get your forms from these official providers as anything else will be unacceptable place a checkmark on either of the two boxes above indicating void or corrected fill in payers name street address city state zip code and telephone number below this area fill in the payers federal identification number and decided place the policyholders identification number right below fill in the personal information of the policyholder place the name of the policyholder the street address and apartment number the city state and zip code the account number below indicates the number assigned to the holder by the payer to distinguish his particular account proceeded to fill out the boxes on the right side of the form Music on box number one indicate the gross benefits under the long-term care insurance which were paid during the year box number two should be filled with the gross accelerated death benefits that were paid for during the year box number three will contain information regarding as to how the amount on box numbers two and three were paid for whether on a per diem basis or reimbursement of actual expenses on long-term care for terminally ill patients box number three need not be filled box four will indicate if benefits were from a qualified long-term insurance contract or LTC in box 5 fill in whether chronically or terminally ill fill in the latest certified date file the form to the IRS and send copies to recipients visit the official website of the IRS for schedule of filing as changes occur yearly as with any official forms it is always best to be meticulous when completing the form 1099 LTC this forum will benefit you greatly and save you a lot of problems later on should questions.